人工髋关节置换术与内固定术治疗老年股骨粗隆间骨折的META分析  

A meta-analysis of arthroplasty versus internal fixation treatment of intertrochanteric fracture in the elderly

作　　者：向川[1] 郝耀[1] 杨宇君[1] 孙剑[1] 秦迎泽[1] 卫小春[1] 

机构地区：[1]山西医科大学第二医院骨科,太原五一路382号030001

出　　处：《中国矫形外科杂志》2013年第14期1384-1391,共8页Orthopedic Journal of China

摘　　要：[目的]通过Meta分析比较人工髋关节置换术(包括股骨头置换术、全髋关节置换术)与内固定术治疗老年人股骨粗隆间骨折的疗效。[方法]检索1979年1月～2011年1月关于股骨粗隆间骨折采用人工关节置换术与内固定术治疗对照研究的文献(共14篇),采用循证医学Meta分析对患者术后死亡率、术后内科并发症发生率、术后髋部畸形率、术后内置物松动率及术后髋关节功能评分(Harris hip score)进行综合分析。[结果]Meta分析发现,人工股骨头置换术后的髋关节功能评分明显优于内固定术(P<0.000 01),但人工髋关节置换术(股骨头置换术+全髋关节置换术)的术后死亡率却比内固定组高(P<0.01)。在术后髋部畸形率、内科并发症发生率、内置物松动率方面,则均无明显统计学差异。[结论]治疗老年股骨粗隆间骨折,人工髋关节置换术与内固定术在不同评价指标的比较中各有优劣,临床可根据患者的具体情况进行选择。其中股骨头置换术在文中所列指标中,均优于或不差于内固定术,全髋关节置换术在应用时则应慎重考虑。[ Objective] To compare arthroplasty and internal fixation treatment for intertrochanteric fracture in the elderly by meta - analysis. [ Method] The literature published in English or Chinese from 1979 to 2011 on compare between arthroplas- ty and internal fixation treatment of intertrochanteric fracture were searched and analysed. Five English papers and nine Chinese ones were eligibly included in this meta - analysis. The clinical data of the 14 papers were collected for comparing postoperative mortality, postoperative medical complications rate, postoperative hip deformity rate, postoperative loosening rate of implantation and postoperative Harris hip score. [ Result] Arthroplasty led to better result in postoperative Harris hip score than internal fixa- tion （P 〈0.000 01 ） ,but worse result in postoperative mortality （P 〈 0.01 ）. There were no significant differences in other in- dex. [ Conclusion] Arthroplasty and internal fixation play different roles in treatment of intertrochanteric fracture.

关 键 词：股骨粗隆间骨折 内固定术 关节置换术 META分析 

分 类 号：R687.3[医药卫生—骨科学]