微创内固定治疗骨盆前环损伤并发症的荟萃分析  

Complications following minimally invasive internal fixation for anterior pelvic ring injury: a Meta-anaiysis

作　　者：王富明[1,2] 钟子毅 冯子航 林诗源 钟承桔 王钢 Wang Fuming;Zhong Ziyi;Feng Zihang;Lin Shiyuan;Zhong Chengju;Wang Gang(Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou510515, China;Department of Orthopaedics and Traumatology, Chongqing General Hospital, Chongqing 400013, China)

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515 [2]重庆市人民医院创伤骨科,400013

出　　处：《中华创伤骨科杂志》2019年第3期199-206,共8页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金面上项目(81272008).

摘　　要：目的探讨微创内固定治疗骨盆前环损伤的并发症及其发生率。方法计算机检索Pubmed,Cochrane,中国生物医学文献数据库、万方数据库和中国知网等,检索文献发表时间为2009年1月至2018年11月,获取微创内固定治疗骨盆前环损伤并发症的相关文献。记录并发症(股前外侧皮神经损伤、股神经损伤、异位骨化、术后感染及内固定失效等)的发生率,通过R软件Meta软件包中的meta-prop函数进行统计分析。结果29项临床研究共825例患者被纳入本荟萃分析。微创内固定治疗骨盆前环损伤的常见并发症包括股前外侧皮神经损伤、股神经损伤、异位骨化、术后感染及内固定失效,其发生率分别为12%[95%可信区间(CI):7%~19%]、3%(95%CI:2%-4%).30%(95%CI:22%~39%)、4%(95%CI:3%~6%)和4%(95%CI:3%~6%)。结论股前外侧皮神经损伤、异位骨化是微创内固定治疗骨盆前环损伤的常见并发症,尚需就并发症的形成因素及预防措施开展高质量的临床研究。Objective To summarize the complications and their incidences following Anterior Subcutaneous Internal Pelvic Fixation(ASIPF). Methods A comprehensive search was conducted of PubMed Library, Cochrane Library, Web of Science, SinoMed, Wanfang Data and China National Knowledge Internet for all articles addressing the postoperative complications of ASIPF published in English and Chinese from January 2009 to November 2018. A proportion Meta-analysis across the studies was performed for the complications after ASIPF (lateral femoral cutaneous nerve irritation, femoral nerve palsy, heterotopic ossification, infection and implant failure) using R software. Results This meta-analysis included 29 clinical studies involving a total of 825 patients. The complications following ASIPF were lateral femoral cutaneous nerve initation, femoral nerve palsy, heterotopic ossification, infection and implant failure;their incidences were respectively 12%(95% CI: from 7% to 19%), 3%(95% CI:from 2% to 4%), 30%(95% Cl:from 22% to 39%), 4%(95% CI:from 3% to 6%) and 4%(95% CI: from 3% to 6%). Conclusions Lateral femoral cutaneous nerve irritation and heterotopic ossification are common complications following minimally invasive internal fixation for anterior pelvic ring injury. High-quality clinical research is needed into the factors leading to the complications and into their preventive countermeasures.

关 键 词：骨盆 骨折 骨折固定术 内 外科手术 微创性 并发症 

分 类 号：R687.3[医药卫生—骨科学]