经皮球囊扩张椎体后凸成形术与保守治疗骨质疏松性椎体压缩性骨折的Meta分析  

Comparisons of Percutaneous Kyphoplasty and Conservative Treatment on Osteoporosis Vertebra Compression Fracture:a Meta Analysis

作　　者：苏其昌[1] 张汉庆[2] 王晓慧 SU Qichangp;ZHANG Hanqing;WANG Xiaohui(Jianghan University ,Wuhan 430056,Hubei,China;Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,Hubei,China;Fifth Hospital in Wuhan,Wuhan 430050,Hubei,China)

机构地区：[1]江汉大学,湖北武汉430056 [2]武汉市中医医院,湖北武汉430014 [3]武汉市第五医院,湖北武汉430050

出　　处：《江汉大学学报（自然科学版）》2018年第1期77-82,共6页Journal of Jianghan University：Natural Science Edition

摘　　要：目的应用Meta分析方法评价经皮球囊扩张椎体后凸成形术(PKP)与保守方法治疗骨质疏松性椎体压缩性骨折的疗效差异。方法计算机检索Pubmed、Cochrane Library、Embase、中国生物医学文献数据库(Sino Med)、中国知网(CNKI)、万方数据库(Wanfang Standards Database),检索日期至2017年5月,搜集关于经皮球囊扩张椎体后凸成形术与保守方法治疗骨质疏松性椎体压缩性骨折的随机对照试验。严格评价纳入研究的方法学质量并提取资料,统计软件采用Rev Man5.3。结果共纳入6篇随机对照试验文献,共475例患者,PKP组233例,保守组242例。根据改良后的Jadad评分标准,有4篇为高质量文献,2篇为低质量文献,偏倚风险评估为中等。Meta分析显示,PKP组治疗后1周、1个月、3个月VAS疼痛评分低于保守组,差异具有统计学意义(P<0.05),治疗后6个月、12个月VAS评分比较差异无统计学意义(P>0.05)。治疗后3 d、3个月ODI功能障碍评分PKP组均少于保守组,差异具有统计学意义(P<0.05)。结论经皮球囊扩张椎体后凸成形术后早期比保守治疗更能有效缓解疼痛,远期无明显差异,且前者治疗后可获得更好的功能恢复,建议临床推广应用。Objective To evaluate the therapeutic effect of percutaneous kyphoplasty(PKP)and conservative treatment for osteoporosis vertebra compression fracture with Meta analysis. Methods Pubmed,Cochrane Library,Embase,Sino Med,CNKI and Wanfang Standards Database were searched.The retrieval date was before May,2017. The data were percutaneous kyphoplasty and conservative treatment on osteoporosis vertebra compression fractures with a randomized controlled trial. The writer strictly eval-uated the quality of the methodology incorporated into the study and extracted the data,with statisticalsoftware Rev Man 5.3. Results A total of 6 randomized controlled trials with 475 cases were included,233 in the PKP group and 244 in the conservative treatment group. According to the improved Jadadscore,four were high quality literature,two were low quality literature,and the bias risk assessment was moderate.Meta analysis results showed the VAS pain score of the PKP group was lower than that of theconservative treatment group at one week,one month and three months after treatment,which was statis-tically significant( P < 0. 05).The differences were not statistically significant in VAS score at sixmonths and 12 months after treatment( P > 0. 05).After three days and three months of treatment,ODIdysfunction score in the PKP group was less than that in the conservative treatment group,with statisti-cal significance( P < 0. 05). Conclusion Percutaneous kyphoplasty is more effective in relieving painthan the conservative treatment in early stage and it is not significant different in long-term. Besides,the former treatment has a better function recovery,it is recommended for clinical application.

关 键 词：骨质疏松性椎体压缩性骨折 经皮球囊扩张椎体后凸成形术 保守治疗 META分析 

分 类 号：R683.2[医药卫生—骨科学]