经髌上入路与经髌韧带入路交锁髓内钉内固定治疗胫骨骨折疗效比较的Meta分析  

Meta analysis of clinical effect of intramedullary nail internal fixation by suprapatellar approach and infrapatellar approach for treatment of tibia shaft fractures

作　　者：王磊[1] 张杰[1] 马改平[1] 呼芳[1] 王凤凤[2] 曹华佗 WANG Lei;ZHANG Jie;MA Gai-ping;HU Fang;WANG Feng-feng;CAO Hua-tuo(Department of Trauma and Restitution,Yan'an University of Affiliated Hospital,Yan'an,Shaanxi 716000,China)

机构地区：[1]延安大学附属医院创伤修复外科,陕西延安716000 [2]延安大学附属医院血液免疫科 [3]延安市人民医院脊柱外科

出　　处：《中国骨与关节损伤杂志》2019年第8期804-807,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的采用Meta分析对经髌上入路与经髌韧带入路交锁髓内钉内固定治疗胫骨骨折的临床疗效进行比较。方法检索自1966-01-2018-01国内外数据库有关经髌上入路与经髌韧带入路交锁髓内钉内固定治疗胫骨骨折的对照研究文献。观察指标:术中X线暴露时间、手术时间、术中出血量、术后膝前疼痛发生率、骨折愈合时间、术后膝关节功能优良率、术后膝关节疼痛VAS评分。采用Cochrane协作网提供的Review Manager 5.2软件对数据进行分析。结果纳入7个研究,共440例,其中经髌上入路组221例,经髌韧带入路组219例。纳入文献质量:A级2个,B级2个,C级3个。与经髌韧带入路组比较,经髌上入路组术中X线暴露时间与手术时间更短,术后膝前疼痛发生率更低,差异有统计学意义(P <0.05)。但2组术中出血量、骨折愈合时间、术后膝关节功能优良率、术后膝关节疼痛VAS评分差异无统计学意义(P>0.05)。结论采用交锁髓内钉内固定治疗胫骨骨折时,相对于经髌韧带入路,经髌上入路可以降低术后膝前疼痛的发生率,减少术中X线暴露时间并缩短手术时间。Objective To compare the clinical effect of intramedullary nail internal fixation by the suparpatellar approach and by infrapatellar approach for treatment of tibia shaft fractures by Meta analysis.Methods Articles of clinical controlled study of the clinical effect of intramedullary nail internal fixation by suparpatellar approach and infrapatellar approach for treatment of tibia shaft fractures were searched in domestic and foreign database from January 1966 to January 2018.The amount of operative bleeding,fluoroscopy time,the time of operation,fracture healing time,the excellent function of knee,incidence of postoperative knee pain,postoperative VAS score were evaluated.Review Manager 5.2 by the Cochranel library was used for data analysis.Results Seven articles were included and 440 patients met the evaluation criterion.For methodology quality of literatures,2 were A,2 B,3 C.The corresponding results showed that suparpatellar approach method for treatment of tibia shaft fractures reduced fluoroscopy time,the time of operation,incidence of postoperative knee pain.There were no significant difference in amount of operative bleeding,fracture healing time,the excellent function of knee,postoperative VAS score (P >0.05).Conclusion With the intramedullary nail internal fixation for treatment of tibia shaft fractures,compared with infrapatellar approach,the suparpatellar approach method can reduce the incidence of postoperative knee pain,the fluoroscopy time and the time of operation.

关 键 词：胫骨骨折 交锁髓内钉 经髌韧带入路 经髌上入路 META分析 

分 类 号：R687.3[医药卫生—骨科学]