全髋关节置换过程中使用保留股骨颈假体有效和安全性的系统评价  

Systematic evaluation of the efficacy and safety of collum femoris preserving prosthesis in total hip arthroplasty

作　　者：黄和涛[1] 潘建科 杨伟毅 曾令烽 梁桂洪 刘军 Huang Hetao;Pan Jianke;Yang Weiyi;Zeng Lingfeng;Liang Guihong;Liu Jun(the Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学第二临床医学院,广东省广州市510405 [2]广州中医药大学第二附属医院,广东省中医院,广东省广州市510405

出　　处：《中国组织工程研究》2020年第6期962-967,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省医学科学技术研究基金资助项目(A2017215)，项目负责人：潘建科;广东省财政厅项目([2018]8号)，项目负责人：刘军~~

摘　　要：背景:保留股骨颈假体的全髋关节置换正在被越来越多的医生认可,但股骨颈假体保留与否对全髋关节置换疗效的影响暂时无法判断。目的:系统评价全髋关节置换过程中使用保留股骨颈假体的有效性和安全性。方法:系统检索中国生物医学文献数据库(CBM)、中国期刊全文数据库(中国知网/CNKI)、维普期刊数据库、万方资源数据库、PubMed、Embase、The Cochrane Library,检索截止时间为:2018-03-01。收集所有全髋关节置换过程中使用保留股骨颈假体的临床对照试验,并对其逐个进行方法学质量评价并采用RevMan4.2软件进行系统评价。结果与结论:①共纳入4篇研究,包括302例患者。由于纳入的研究及患者太少,且结局评价指标差异较大,不能进行Meta分析,只能进行描述性系统评价;②3个研究比较了2种手术方式在改善患者Harris评分方面的疗效差异,其中2个研究认为使用保留股骨颈假体全髋关节置换明显优于非保留股骨颈假体全髋关节置换(P <0.05),另1个研究则认为2种手术方式在改善Harris评分方面差异无显著性意义(P> 0.05);③2个研究比较了2种手术方式在改善患者关节活动度方面的疗效差异,1个研究结果显示使用保留股骨颈假体全髋关节置换明显优于非保留股骨颈假体全髋关节置换(P <0.05),另1个研究结果则提示2种手术方式在改善患者关节活动度方面差异无显著性意义(P>0.05);④1个研究结果显示使用保留股骨颈假体全髋关节置换组术后1年的假体周围骨量丢失明显少于非保留股骨颈假体全髋关节置换组(P<0.05);⑤1个研究认为使用保留股骨颈假体全髋关节置换组在改善术后1年的目测类比评分方面优于非保留股骨颈假体全髋关节置换组(P<0.05);⑥2个研究认为全髋关节置换术后1年无假体松动、下沉等不良假体事件发生;⑦2个研究比较了在手术时间、术中出血量方面的差异,结果显�BACKGROUND: Total hip arthroplasty with femoral neck prosthesis is being accepted by more and more doctors, but the effect of femoral neck prosthesis preservation or not on total hip arthroplasty is still uncertain. OBJECTIVE: To systematically evaluate the efficacy and safety of collum femoris preserving prosthesis in total hip arthroplasty. METHODS: CBM, CNKI, VIP, WanFang, PubMed, Embase and The Cochrane Library databases were searched systematically. The deadline was March 1, 2018. All clinical controlled trials collum femoris preserving prosthesis in total hip arthroplasty were collect ed and methodological quality was evaluated one by one. RevMan 4.2 software was used for systematic evaluation. RESULTS AND CONCLUSION:(1) Four studies were included, involoing 302 patients. Because there were few studies and patients involved, and the outcome evaluation indicators were quite different, meta-analysis cannot be conducted, only descriptive systematic evaluation was performed.(2) Three studies compared the efficacy of two surgical methods in improving Harris score. Two of them considered that total hip arthroplasty with collum femoris preserving prosthesis was significantly better than total hip arthroplasty with non-collum femoris preserving prosthesis(P < 0.05). The other one considered that there was no significant difference between two surgical methods in improving Harris score(P > 0.05).(3) Two studies compared the efficacy of two surgical methods in improving the range of motion of the joint. One study showed that total hip arthroplasty with collum femoris preserving prosthesis was significantly better than total hip arthropl asty with non-prosthesis(P < 0.05). The other showed that there was no significant difference between the two surgical methods in improving the range of motion of the joint(P > 0.05).(4) One study showed that bone loss around the prosthesis in the total hip arthroplasty group with prosthesis was significantly less than that in the total hip arthroplasty group without collum femoris pr

关 键 词：保留股骨颈 全髋关节置换 疼痛 假体松动 系统评价 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]