空心拉力钉和克氏针张力带治疗髌骨骨折疗效的Meta分析  

Meta-analysis on effectiveness of cannulated screw band versus Kirschner tension band treatment in patients with patella fracture

作　　者：郭二鹏[1,2,3] 李宽新[3] 李建柱[1,2,3] 孙开军[1,2,3] 史东[1,2,3] 王维山[1,2] 史晨辉[1,2,3] 

机构地区：[1]石河子大学临床医学院,新疆石河子832002 [2]石河子大学医学院地方病实验室,新疆石河子832002 [3]石河子大学医学院第二附属医院新疆生产建设兵团医院关节脊柱外科,新疆乌鲁木齐830000

出　　处：《吉林大学学报（医学版）》2015年第3期606-611,共6页Journal of Jilin University：Medicine Edition

基　　金：新疆生产建设兵团科技创新团队专项基金资助课题(2014CC002);新疆生产建设兵团医药卫生专项基金资助课题(2013BA020);新疆生产建设兵团国际交流与合作专项基金资助课题(2012BC002,2011BC004)

摘　　要：目的:利用Meta分析方法系统分析空心拉力钉(CSB)与克氏针张力带(KTB)内固定术治疗髌骨骨折的疗效差异,为临床选择不同类型髌骨骨折的手术治疗方法提供客观依据。方法:由2名研究者独立检索PubMed、Cochrane Library、EMbase、中国期刊全文数据库、中国生物医学文献数据库和万方数据库(1997年1月—2014年9月),手工检索相关期刊。搜集关于CSB和KTB治疗髌骨骨折的对照研究。2名研究者独立评估各研究的质量,将各研究中的手术后疗效、骨折愈合时间、术后并发症和手术时间提取后,利用RevMan 5.1软件进行Meta分析与综合。结果:共10篇研究符合纳入标准,共计734例患者被纳入分析研究。Meta分析,与KTB内固定术比较,CSB内固定术可提高术后疗效(OR=4.00,95%CI:1.56~10.27,P=0.004),缩短骨折愈合时间(MD=-0.76,95%CI:-1.03^-0.48,P<0.01)、减少术后并发症发生率(OR=0.07,95%CI:0.03~0.17,P<0.01)、缩短手术时间(MD=-3.91,95%CI:-7.68^-0.13,P=0.04)。结论:与KTB内固定术比较,CSB可更好地恢复膝关节功能,缩短骨折愈合时间和手术时间,减少术后并发症,是一种理想的手术方式。Objective To compare the efficacy between cannulated screw band（CSB）and Kirschner tension band（KTB）in the treatment of patella fracture with Meta-analysis,and to provide an objective evidence for clinical selection of operation methods in the treatment of different types of patella fracture.Methods The Pubmed databases,the Cochrane Central Register of Controlled Trials,EMbase,CNKI databases,CBM databases and Wanfang databases（1997,01-2014,09）,were retrievaled by two reseachers,respectively;several related journals were searched by hand.The control trials comparing CSB with KTB in the adults were collected.Two researchers independently assessed the trial quality and extracted the data into an electrical sheet.The data of the treatment outcome,the time of fracture healing,the incidence of complications and the operation time from these studies were abstracted and synthesized by Meta-analysis with RevMan 5.1 software.Results A total of10 studies involving 734 patients were included.The results of Meta-analysis showed that in CSB group the treatment outcome was increased（OR=4.00,95%CI：1.56-10.27,P =0.004）,the time of the fracture healing was shortened（MD=-0.76,95%CI：-1.03--0.48,P〈0.01）,the incidence of complications was decreased（OR=0.07,95%CI：0.03-0.17,P〈0.01）and the operation time was shortened（MD=-3.91,95%CI：-7.68--0.13,P=0.04）compared with KTB group.Conclusion CSB is superior to KTB in the intraoperative treatment outcome,time of fracture healing,incidence of complications,and operation time.CSB is an ideal operation to treat the patients with patella fracture.

关 键 词：髌骨骨折 空心拉力钉 克氏针张力带 META分析 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学]