防旋股骨近端髓内钉与人工股骨头置换修复老年股骨转子间骨折的Meta分析  

Proximal femoral nail antirotation versus artificial femoral head replacement for intertrochanteric fracture in the elderly: a meta-analysis

作　　者：裴军朋 杨文龙[1] 兰曦[1] 黄省利[1] 

机构地区：[1]西安交通大学医学院第二附属医院骨科,陕西省西安市710014

出　　处：《中国组织工程研究》2015年第44期7193-7201,共9页Chinese Journal of Tissue Engineering Research

摘　　要：背景:人工股骨头置换和防旋股骨近端髓内钉在修复老年股骨转子间骨折方面哪种更优尚无定论。目的:通过Meta分析比较国内老年人股骨转子间骨折使用人工股骨头置换与防旋股骨近端髓内钉内固定的疗效差异。方法:检索Pub Med、Cochrane、CNKI、万方、维普等数据库,以及《中华骨科杂志》、《中国矫形外科杂志》等近5年发表的相关文献。收集国内老年股骨转子间骨折行人工股骨头置换与防旋股骨近端髓内钉修复的临床对照试验,提取基线资料,采集手术持续时间、术中出血量、术后下床时间、住院时间、Harris评分、并发症率和死亡数等数据,并用Rev Man 5.30对所提取数据结果进行Meta分析处理。结果与结论:共纳入37个临床对照研究,共3 216例患者。Meta分析结果显示,与人工股骨头置换相比,防旋股骨近端髓内钉在术后下床、住院时间及早期关节功能方面处于劣势;而两者在并发症及死亡率上差异并无显著性意义。但防旋股骨近端髓内钉具有手术持续时间短、创伤小、术中出血少等优点,也具有较好的中远期关节功能预期效果。BACKGROUND： Proximal femoral nail antirotation and femoral head replacement could quickly recover hip function in intertrochanteric fractures in the elderly, but whose efficacy is better remains controversial. OBJECTIVE： To compare the differences in the effects of proximal femoral nail antirotation and femoral head replacement on intertrochanteric fractures in the elderly by using a meta-analysis. METHODS： The relevant literatures were searched in Pub Med, Cochrane, CNKI, Wanfang database and VIP, and other relevant journal such as Chinese Journal of Orthopaedics and Orthopedic Journal of China for articles published in recent five years. Randomized controlled trials concerning proximal femoral nail antirotation and femoral head replacement for the treatment of intertrochanteric fractures in the Chinese elderly were collected. Baseline data, operation time, intraoperative blood loss, postoperative out-of-bed time, length of stay, Harris score, complication rate and number of death were collected and processed using Rev Man 5.30 software for meta analysis. RESULTS AND CONCLUSION： Totally 37 clinical controlled trials with 3 216 patients were recruited. Meta-analysis results showed that compared with femoral head replacement, proximal femoral nail antirotation was at a disadvantage in postoperative out-of-bed time, length of stay and joint function in the early stage. No significant difference in complication and mortality was detected between proximal femoral nail antirotation andfemoral head replacement. However, proximal femoral nail antirotation had some advantages such as short operation time, small trauma, and less intraoperative blood loss, and showed good midterm and long-term outcomes of joint function.

关 键 词：骨科植入物 骨植入物 股骨转子间骨折 股骨头置换 防旋股骨近端髓内钉 并发症 META分析 

分 类 号：R318[医药卫生—生物医学工程]