创伤性中枢神经系统损伤与骨折愈合关系研究的Meta分析  

A Meta-analysis on correlation between traumatic central nervous system injury and bone fracture healing

作　　者：章冲[1] 余国荣[1] Zhang Chong;Yu Guorong(Department of Orthopedics,Zhongnan Hospital of Wuhan University,Wuhan Hubei,430071,China)

机构地区：[1]武汉大学中南医院骨科,湖北武汉430071

出　　处：《生物骨科材料与临床研究》2018年第6期22-28,共7页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的系统评价骨折合并创伤性中枢神经系统损伤患者与单纯骨折患者骨折愈合及骨痂生成的差异,探讨创伤性中枢神经系统损伤对骨折愈合的促进关系及相关作用机制。方法计算机检索PubMed、EMbase、VIP(维普)、CNKI(中国知网)和万方数据库,查询有关骨折伴创伤性中枢神经系统损伤与单纯骨折在骨折愈合方面的队列研究。检索时限均为建库至2017年11月,由2个人按纳入、排除标准独立对文献进行筛选、资料提取、质量评价及Meta分析。结果共纳入9个研究(均为创伤性脑外伤,未有符合标准脊髓损伤纳入),636例患者。Meta分析结果显示:与单纯骨折组相比,脑外伤并骨折组骨折愈合时间较短[SMD=-1.43,95%CI (-2.03,-0.83),<0.00001];脑外伤并骨折组在第4、8、12周骨痂出现率高于单纯骨折组[RR=3.19,95%CI (1.62,6.28),=0.0008]、[RR=3.08,95%CI (1.90,5.00),<0.00001]、[RR=1.78,95%CI (1.42,2.23),<0.00001];脑外伤并骨折组在第4、8周正侧位骨痂生成量上多于单纯骨折组[MD=1.42,95%CI (1.38,1.46),<0.00001]、[MD=1.20,95%CI (1.19,1.21),<0.00001]、[MD=1.50,95%CI (1.46,1.54),<0.00001]、[MD=1.24,95%CI (1.23,1.26),<0.00001]。结论创伤性中枢神经系统损伤能促进骨折的愈合以及骨痂的生成。Objective To investigate the difference of bone fracture healing and the callus formation rate between bone fracture combined traumatic central nervous system injury and simple bone fracture through Meta-analysis and prove that traumatic central nervous system can accelerate bone fracture healing. Methods The databases of PubMed, EMbase, VIP,CNKI and WanFang Database were retrieved with computer(until Nov, 2017) for searching the cohort studies related to the correlation between traumatic central nervous system injury and bone fracture healing, the references of those researches were also searched by hand. All documents were read and screened strictly according to exclusion criteria. The data were extracted and given a Meta-analysis. Results There were totally 9 studies included involving 636 cases(all researches are about traumatic brain injury). The Meta-analysis showed that the time of bone fracture healing of traumatic brain injury fracture group is significantly shorter [SMD=-1.43,95%CI(-2.03,-0.83), <0.00001] than that of simple fracture group. the callus formation rate of simple fracture group on 4, 8, 12 weeks were significantly lower[RR=3.19, 95%CI(1.62, 6.28), =0.0008], [RR=3.08, 95%CI(1.90, 5.00), <0.00001], [RR=1.78, 95%CI(1.42, 2.23), <0.00001] than that of traumatic brain injury fracture group. the amount of callus of simple fracture group on 4, 8 weeks were significantly lower [MD=1.42, 95%CI(1.38, 1.46), <0.00001], [MD=1.20, 95%CI(1.19, 1.21), <0.00001], [MD=1.50, 95% CI(1.46, 1.54), <0.00001], [MD=1.24, 95% CI(1.23, 1.26),<0.00001] than that of traumatic brain injury fracture group. Conclusion Traumatic central nervous system injury can accelerate bone fracture healing and callus formation.

关 键 词：脑外伤 骨折 骨折愈合 META分析 

分 类 号：R651[医药卫生—外科学]