两种截骨术治疗儿童发育性髋关节脱位的荟萃分析  

Comparison of Salter osteotomy versus Pemberton osteotomy for developmental dysplasia of the hip in children:a meta analysis

作　　者：杨锐[1] 俞驰 彭岗[1] 唐仕忠[1] YANG Rui;YU Chi;PENG Gang;TANG Shi-zhong(Guizhou Provincial People’s Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院,贵州贵阳550000

出　　处：《中国矫形外科杂志》2020年第15期1395-1398,共4页Orthopedic Journal of China

摘　　要：[目的]对比分析Salter截骨术、Pemberton截骨术治疗儿童发育性髋关节脱位的临床疗效和安全性。[方法]从Pubmed、Embase、CNKI、维普和万方等数据库搜索、获得关于Salter截骨术、Pemberton截骨术治疗儿童发育性髋关节脱位的相关研究,按纳入与排除标准进行筛选,符合条件的文献纳入本研究,采用Ran Man 5.3软件进行荟萃分析,比较两种术式的McKay髋关节功能评级优良率、中心边缘角(CE)改善情况、髋臼指数改善情况和股骨头坏死率。[结果]共纳入7篇病例对照研究;涉及596例患者,其中Salter截骨术组315例,Pemberton截骨术组381例。荟萃分析结果显示:两种截骨术在McKay髋关节功能评级优良率(RR=1.04,95%CI 0.97, 1.11,P=0.31),CE角改善情况(WMD=-1.18,95%CI-4.30,1.94,P=0.46)的差异无统计学意义;但是,在改善髋臼指数方面,Pemberton截骨组显著优于Salter截骨组(WMD=-6.18,95%CI-9.66,-2.69,P<0.001);而Salter截骨术的股骨头坏死率明显低于Pemberton截骨术(OR=0.34,95%CI 0.12,0.98,P=0.05)。[结论] Salter截骨术与Pemberton截骨术均是治疗儿童发育性髋关节脱位的有效手术方式,在改善髋臼指数方面,Pemberton截骨术优于Salter截骨术,但Salter截骨术在降低股骨头坏死率方面明显优于Pemberton截骨术。[Objective]To compare the efficacy and safety of the Salter osteotomy versus Pemberton osteotomy for developmental dislocation of the hip in children.[Methods]The researches on Salter osteotomy and Pemberton osteotomy for developmental dislocation of the hip in children were retrieved from PubMed,EMBASE,CNKI,VIP,Wanfang and the other databases.After screening based on the including and extruding criteria,the qualified articles were enrolled into this study,and then analyzed by Ran Man 5.3 to compare the excellent and good rate in term of McKay grading,center-edge angle(CE)of acetabulum,acetabular index and the rate of femoral head necrosis between two osteotomies.[Results]A total of 7 articles were enrolled,involving 596 patients,including 315 patients in the Salter osteotomy group and 381 patients in the Pemberton osteotomy group.As results of the meta-analysis,there were no statistically significant differences regarding McKay grading and CE of acetabulum between the two groups(P>0.05),however,the Pemberton osteotomy group was significantly better than the Salter osteotomy group in improving acetabular index(WMD=-6.18,95%CI-9.66,-2.69,P=0.0005),but the Salter osteotomy group had significantly lower rate of femoral head necrosis than the Pemberton osteotomy group(OR=0.34,95%CI 0.12,0.98,P=0.05).[Conclusion]Both of the Salter osteotomy and Pemberton osteotomy are effective surgeries for treating developmental dislocation of the hip in the children.Pemberton osteotomy is better than Salter osteotomy in improving acetabular index,but Salter osteotomy is better than Pemberton osteotomy in reducing necrosis rate of femoral head.

关 键 词：SALTER截骨术 Pemberton截骨术 发育性髋关节脱位 荟萃分析 

分 类 号：R726.8[医药卫生—儿科]