尺神经肌下前置术与皮下前置术治疗肘管综合征的Meta分析  

Anterior subcutaneous transposition versus anterior submuscular transposition of the ulnar nerve in the treatment of cubital tunnel syndrome:A Meta-analysis

作　　者：柴浩[1] 张磊 孙荣鑫[1] 

机构地区：[1]新疆医科大学第六附属医院关节镜科,新疆乌鲁木齐830092 [2]新疆武警兵团指挥部医院,新疆乌鲁木齐830063

出　　处：《中国骨伤》2016年第4期355-360,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :通过Meta分析对尺神经皮下前置术(ASCT)与肌下前置术(ASMT)治疗肘管综合征的有效性和安全性进行比较。方法:按照Cochrane系统评价方法,计算机检索Medline,荷兰医学文摘(EMBase),Cochrane图书馆、Cochrane协作网专业实验数据库、中国生物医学文献数据库(CBM)、CNKI等,并采用手工检索方法收集相关随机对照试验及半随机对照试验。采用Review Manager 5.3软件进行Meta分析。结果:共纳入7个研究,Meta分析结果显示:尺神经皮下前置术与肌下前置术治疗肘管综合征在手术后小指指端两点辨别觉、手术优良率、手术并发症、手术切口长度方面差异无统计学意义。在手术时间方面,皮下前置术较肌下前置术短。结论:皮下前置术(ASCT)与肌下前置术(ASMT)均是治疗肘管综合征的有效方法。尺神经皮下前置术操作简单,手术后无须进一步固定,恢复较快,尤其适用于肥胖及老年患者。尺神经肌下前置术适用范围较广但操作较复杂。由于部分文献质量不高,可能存在各种偏移,需要更多高质量的随机对照试验来得出更可靠的结论。Objective：To compare the efficacy and safety between of anterior subcutaneous transposition（ASCT） and anterior submuscular transposition（ASMT） of the ulnar nerve in treatment of cubital tunnel syndrome by Meta-analysis.Methods：According to Cochrane system evaluation method,the data were retrieval by computer from Medline（1995-2015.04）,Embase（1995-2015.04）,Cochrane,CBM and CNKI;randomized controlled trials（RCTs）,quasi-RCT and CCT were handserched.The data were extracted and analyzed by Meta-analysis of Revman 5.3 software.Results：Seven trials were included.The combined results of Meta analysis showed that there was no difference in distribution sense of two points at little thrumb postoperative,the rate of excellent and good after operatio,operative complications and incision length.ASCT had shorter operative time.Conclusion：Both ASCT and ASMT are effective treaments for cubital tunnel syndrome.ASCT has advantages of simple procedure,no further fixed after the surgery,recover quickly,especially applicable to obesity and elderly patients.ASMT has a wide applicable scope but complicated operation.Ulnar nerve submuscular front technique has a wide applicable scope but complicated operation.Because of lack of enough,the conclusion may be bias,so more randomized controlled trials are required.

关 键 词：肘管综合征 尺神经 外科手术 随机对照试验 META分析 

分 类 号：R195.1[医药卫生—卫生统计学]