骨水泥型股骨头置换治疗高龄患者股骨颈骨折有效性与安全性随机对照研究的Meta分析  

Effectiveness and safety of cemented hemiarthroplasty for femoral neck fractures in elderly patients： a meta-analysis

作　　者：李涛[1] 翁习生[1] 周磊[1] 边焱焱[1] 孙天闻[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院骨科,北京100730

出　　处：《中华创伤骨科杂志》2013年第8期645-652,共8页Chinese Journal of Orthopaedic Trauma

摘　　要：【摘要】目的通过Meta分析对骨水泥阡lJ股骨头置换治疗高龄患者股骨颈骨折的有效性与安全性进行评价。方法计算机检索PubMed、Embase、Cochrane图书馆、小国期刊全文数据库、维普ffl文科技期刊数据胯等，榆索时间均为建库至2012年12月，获取骨水泥型股骨头博换（骨水泥组）与非骨水泥掣股骨头嚣换（非骨水泥组）治疗高龄患者骨质疏松性股骨颈骨折的随机对照试验。比较两组患者的术后天节功能、病死率、许发症发生率、手术时间、术中出血最及阿手术率等。采ⅢRevMan5．2统计学软件进行Mela分析。结果共纳入7篇随机对照试验，共1108例患者1115髋。文献质量评价结果硅示纳入研究质疑较高、Meta分析结果显示：与非骨水泥组比较，骨水泥组患者术后关节功能恢复良好，假体相关并发症发生率更低fOR=0．15，95％c，（0．09，0．26），P〈0．001]，但手术时间延长【MD=7．43，95％Ct（5．37，9．49），P〈0．001]。两组患者局部并发症发生率、其他并发症发生率、痫死率、术中出血量及财手术率比较差异均无统计学意义（P〉0．05）j结论与非骨水泥型股骨头置换术相比，骨水泥型股骨头置换治疗高龄患者股骨颈骨折虽然手术时间延长，但术中出血量未见明显增加，且具有术后关节功能恢复快、假体相关并发症少等优点，同时不增加病死率及再手术率.Objective To assess the effectiveness and sat＇ely of cemented hemiarlhroplasty for femoral neck fractures in elderly patients through a mate-analysis of randomized t;ontrolled trials （RCTs）. Methods RCTs comparing cemented hemiarthroplasty （CH） and uncemented hemiarthroplasty （UCH） for femoral neck fractures beI＇ore December 2012 were identified from the PubMed, EMBase, Cochrane Lihrary, CNKI and VIP databases through computer search. Relevant references were also searehed manually. The eligible R（~＇rs were collected. Next we extracted the relevant data which were evaluated by Review Manager software 5.2 for meta-analysis. Odds ralio （OR） of mortality, the rates of complications and reoperation, weighted mearl dii＇ference （MD） of operation time and intraoDerative blood loss in the CH and UCH groups were calculated at＇ross the trials. Deseriptive analysis was ased for the postoperative hip function. Results Seven RCTs involving 1115 hips met the selection criteria. The methodological quality of all the 7 trials was high. The recta-analysis showed thai CH had better postoperative hip function and decreased rate of compli-cations related to the prosthesis

关 键 词：股骨颈骨折 关节成形术 置换 髋 骨水泥 META分析 老年人 

分 类 号：R687.3[医药卫生—骨科学]