微创手术治疗外翻畸形的Meta分析  

A Systematic Review of the Minimal Invasive Surgery of Hallux Valgus

作　　者：许灿[1] 张明彦[2] 章灿[1] 刘华[1] 文霆[1] 雷光华[1] 李康华[1] 

机构地区：[1]中南大学附属湘雅医院,湖南长沙410008 [2]广西医科大学第一附属医院,广西南宁530021

出　　处：《实用骨科杂志》2013年第1期23-29,共7页Journal of Practical Orthopaedics

摘　　要：目的系统评价微创手术治疗外翻畸形的有效性和安全性。方法电子检索The Cochrane Library、ISIWeb of science、Pubmed、EMBASE、CNKI、CBMdisc等数据库,检索时间始于各数据库起始日期,截止至2012年3月12日,并辅以手工检索和附加检索,收集公开发表的关于微创手术治疗外翻畸形的研究文献,按Cochrane系统评价方法选择文献、提取资料并评价纳入研究质量后,采用RevMan5.1软件进行Meta分析。结果共纳入25篇文献,合计2 391例患者,由于绝大部分文献是自身前后对照的病例系列研究,并且各研究间存在较大差异,有显著异质性,不符合Meta分析条件,故采用描述性分析。分析结果显示:多数研究提示微创手术治疗外翻疗效明确,2个病例对照研究显示微创手术与传统手术疗效无差异,而微创手术并发症发生率是否高于传统手术尚不明确。结论微创手术可以有效治疗外翻,但尚无有力证据证明其疗效优于传统开放手术。微创手术的安全性尚不明确。由于纳入研究质量不高,各研究治疗方案不统一,报告不标准和不全面,降低了该结论的可靠性,但仍应关注微创手术治疗外翻的益处。未来需要进一步采用一致的干预、随访方法和全面报告结果的准则,进行大样本、前瞻性对照研究。Objective To evaluate the efficacy and safety of minimally invasive surgery of hallux valgus. Methods The databases such as Cochrane Lihrary,ISI Web of science,Puhmed,EMBASE,CNKI,CBMdisc were searched, and the relevant journals and conference proceedings were also manually retrieved. Then the studies were screened ac cording to predefined inclusion and exclusion criteria,and their quality was evaluated. Meta analysis were performed by using RevMan 5.1 software. Results Twentyfive articles involving 2391 patients were included. All of the includ ed research had deficiencies in methodological quality. Given the low document quality and the significan theterogeneity,Metaanalysis was not conducted and only the content of the articles were presented. The results of analysis showed that the minimally invasive surgery of hallux valgus had significantly efficacy. 2 case control research es showed that the minimally invasive surgery had similar efficacy with open surgery. The complications of minimally invasive surgery were still not very clear. Conclusion The minimally invasive surgery of hallux valgus had signifi cantly efficacy,but it＇s not clear that if its efficacy was superior to the open surgery. The safety of the minimally inva sive surgery is not very clear up to now. There are some limitations in existing studies such as indefinite information, unstandard or unilateral report,which reduces the reliability of the conclusionFurther studies should be designed as prospective controlled study carried out in larger samples and use generally accepted rrlethod of measurement. The findings should be reported completely.

关 键 词：微创 外翻 疗效 安全性 META分析 

分 类 号：R682.16[医药卫生—骨科学]