关节镜有限清理术治疗不同分级膝关节骨性关节炎疗效的Meta分析  

Limited arthroscopic joint debridement for the treatment of knee osteoarthritis with different grades: A meta-analysis

作　　者：吴星火[1] 伍振威 孟春庆[1] 段德宇[1] 杨述华[1] 王洪[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,湖北武汉430022 [2]湖北武汉市十一医院骨科,湖北武汉430030

出　　处：《中国内镜杂志》2015年第6期592-597,共6页China Journal of Endoscopy

摘　　要：目的关节镜辅助下关节清理术是治疗膝关节骨性关节炎的一种微创治疗方法,该研究通过循证医学的方法评价关节有限清理术治疗膝关节骨性关节炎的疗效。方法通过计算机检索中国期刊全文数据库(CNKI)、万方数据库(WANFANG DATA)、中国生物医学文献数据库(CBM)和Medline(检索年限2002年8月-2012年8月),纳入比较分析关节镜下有限清理术治疗膝关节骨性关节炎的各类临床研究,以Graphpad Prism 5统计软件包及Rev Man5分析软件对数据进行Meta分析,并计算95%可信区间(CI)。结果该研究最终纳入18篇文献,其中,12篇英文文献、6篇中文文献,共包括2 502个膝关节。Meta分析从总体上显示,关节镜下有限清理术可改善各级骨性关节炎患者的症状,术后患者的关节功能评分较术前均明显改善,手术优良率大于60%;术前关节炎越严重,术后再次手术率也就越高。结论关节镜下有限清理术是治疗膝关节骨性关节炎的一中有效的、微创的治疗方法,对轻中度骨性关节炎患者可获得满意的疗效,对重度患者也可以在一定程度上缓解症状;严格掌握手术适应证,分型而治,可提高手术满意率。【Objective】The meta-analysis aimed to collect and analyze the effects of limited arthroscopic joint debridement for the treatment of knee osteoarthritis. 【Methods】A computer-based online search of Medline, CBM,CNKI and WANFANG DATA（from the August 2002 to the August 2012） for the clinical reports of arthroscopic surgery treatment for KOA was conducted, the study selection, data collection, assessment and analyses were undertaken using Graphpad Prism 5 and Rev Man 5.0 software. 【Results】18 studies（12 English papers, 6 Chinese papers） involving 2502 knee joints were included. Meta-analysis indicated that limited arthroscopic joint debridement could improve the patient＇s clinical symptoms, and the patients could gain better outcome scores after operations.This procedure resulted in an excellent or good outcome in more than 60% of the fellow-up patients. The more serious pre-operative arthritis was, the higher re-operation rate was after operation. 【Conclusion】The limited arthroscopic joint debridement is an effective and minimally invasive method for the treatment knee arthritis. This method could obtain satisfactory outcomes in patients with mild-to-moderate osteoarthritis, and it also could relieve clinical symptoms in patients with serious osteoarthritis. The key points for the treatment are strict selection of operative indications, classification based treatments.

关 键 词：关节镜 有限清理术 分级 关节炎 META分析 

分 类 号：R684.3[医药卫生—骨科学]