下尺桡关节脱位手术治疗与保守治疗疗效Meta分析  

Meta analysis of surgical treatment and conservative treatment of dislocation of the distal radioulnar joint

作　　者：杨杰[1] 祁庆彬[1] 贾珊珊[1] 孟凡雯 许会敏[1] YANG Jie QI Qingbin JIA Shanshan Meng Fanwen XU Huimin.(Department of Bone Surgery ,Langfang People＇s Hospital,Hebei Province, Langfang 065000, Chin)

机构地区：[1]河北省廊坊市人民医院骨二科,065000

出　　处：《疑难病杂志》2017年第5期509-514,共6页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的系统评价下尺桡关节脱位保守治疗与手术治疗的临床疗效。方法计算机检索词EMBASE,PubMed等外文数据库及中国期刊全文数据(CNKI)、万方数据库、维普数据库、中国生物医学文献数据库(CBM);检索时间从建库至2015年4月,对符合纳入标准的文献进行资料提取和质量评价,采用Revman软件进行分析。结果最终纳入9篇文献,共计患者579例,其中接受保守治疗患者264例,手术治疗患者315例。下尺桡关节脱位的手术治疗与保守治疗后疼痛情况差异无统计学意义(OR=1.02,95%CI0.44~2.36,P=0.96),治疗后发生感染的几率明显高于保守治疗,差异具有统计学意义(OR=0.25,95%CI0.07~0.85,P=0.03),治疗后发生骨性关节炎几率明显高于保守治疗,差异具有统计学意义(OR=0.12,95%CI0.02~0.93,P=0.04),治疗后关节强度指数间差异无统计学意义(OR=0.61,95%CI0.13~2.99,P=0.54),治疗后复发几率间差异无统计学意义(OR=0.95,95%CI0.39~2.34,P=0.92),治疗后关节预后功能恢复间差异无统计学意义(OR=0.03,95%CI-0.24~0.31,P=0.81),治疗后随访优良率间差异无统计学意义(OR=1.09,95%CI0.45~2.64,P=0.85)。结论下尺桡关节脱位通过保守治疗与手术治疗后疼痛情况、关节强度指数、复发率、关节预后功能恢复、随访优良率差异均无统计学意义,但手术治疗后发生感染、骨性关节炎几率均明显高于保守治疗。Objective To evaluate the clinical effect of conservative treatment and surgical treatment of dislocation of the radioulnar joint.Methods Computer retrieval EMBASE,PubMed database and Chinese full-text data（CNKI）,Wanfang database,VIP database,Chinese biomedical literature database（CBM）;the retrieval time from inception to April 2015,to meet the inclusion criteria and literature quality evaluation data,were analyzed by Revman software.Results Finally,a total of 9 patients were included in this study.Among them,there were 579 patients who received conservative treatment,and the other patients were treated with surgery in 264 cases.No statistically significant differences in pain of surgical treatment and conservative treatment of distal radioulnar joint dislocation（OR = 1.02,95%CI 0.44-2.36,P = 0.96）,surgical treatment of distal radioulnar joint dislocation occurred after the risk of infection was higher than that of conservative treatment,the difference was statistically significant（OR =0.25,95%CIO.07-0.85,P =0.03）,surgical treatment radioulnar joint dislocation occurred after osteoarthritis was significantly higher probability of conservative treatment,the difference was statistically significant（OR =0.12,95%CI,0.02-0.93,P =0.04）,no statistical significance of surgical treatment and conservative treatment of distal radioulnar joint dislocation after joint strength index difference（OR =0.61,CI 95%0.13-2.99,P = 0.54）,no significant surgical treatment with the conservative treatment of distal radioulnar joint dislocation recurrence probability difference（OR =0.95,CI 95%0.39-2.34,P =0.92）,distal radioulnar closed No statistical significance of conservative treatment and surgical treatment of joint dislocation recovery after the treatment outcome differences（OR =0.03,95%CI-0.24 to 0.31,P =0.81）,no statistical significance of surgical treatment and conservative treatment of distal radioulnar joint dislocation after follow-up excellent rate difference（OR =1.09,95%CI 0.45-2.64,P =0.85）

关 键 词：下尺桡关节脱位 手术治疗 保守治疗 META分析 

分 类 号：R687.4[医药卫生—骨科学]