不同椎弓根入路椎体成形术治疗胸腰椎骨折的网状Meta分析  

Vertebroplasty via different pedicle approaches for treatment of thoracolumbar spine fractures:a network Meta-analysis

作　　者：唐福波[1] 莫怡[1] 万通 张家立[1] 钟远鸣[1] 李智斐[1] 黄保华[1] 钟锡锋 吴卓檀 何炳坤 吴思贤 TANG Fu-bo;MO Yi;WAN Tong;ZHANG Jia-li;ZHONG Yuan-ming;LI Zhi-fei;HUANG Bao-hua;ZHONG Xi-feng;WU Zhuo-tan;HE Bing-kun;WU Si-xian(Department of Orthopedics,the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530001,China;Graduate School,Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学第一附属医院骨科,南宁市530001 [2]广西中医药大学研究生院,南宁市530001

出　　处：《广西医学》2022年第1期80-86,共7页Guangxi Medical Journal

基　　金：国家自然科学基金(81760874);广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200484)。

摘　　要：目的系统评价不同椎弓根入路椎体成形术治疗胸腰椎骨折的有效性与安全性。方法计算机检索万方、中国知网、维普中文数据库、中国生物医学文献数据库、Embase、PubMed、CBM、Cochrane Library等数据库,搜集有关不同椎弓根入路椎体成形术治疗胸腰椎骨折的随机对照试验。筛选文献、提取资料并评价纳入研究的方法学质量后,采用WinBUGS 1.4.3软件进行网状Meta分析。结果共纳入11篇文献,包括1477例患者、3种入路(弯角入路、单侧入路、双侧入路),将11个研究拆分成16个2臂试验进行分析。网状Meta分析结果显示:在目测类比评分方面,双侧入路优于单侧入路、弯角入路优于单侧入路(均P<0.05),从优到劣排序为弯角入路>双侧入路>单侧入路;在手术时间方面,单侧入路优于双侧入路、弯角入路优于双侧入路(均P<0.05),从优到劣排序为弯角入路>单侧入路>双侧入路;在X线曝光次数方面,弯角入路优于双侧入路(P<0.05),从优到劣排序为弯角入路>单侧入路>双侧入路;在骨水泥渗漏率方面,弯角入路优于单侧入路、双侧入路(均P<0.05),从优到劣排序为弯角入路>双侧入路>单侧入路。结论基于目测类比评分、手术时间、X线曝光次数、骨水泥渗漏率等方面考虑,弯角入路治疗胸腰椎骨折的有效性与安全性较单侧或双侧入路更高,或可作为治疗胸腰椎骨折的首选方案。Objective To systematically evaluate the effectiveness and safety of vertebroplasty via different pedicle approaches for the treatment of thoracolumbar spine fractures.Methods A computer-based retrieval was performed in Wanfang Data,CNKI,VIP,SinoMed,Embase,PubMed,CBM,the Cochrane Library and other databases for the randomized controlled trials on vertebroplasty via different pedicle approaches for the treatment of thoracolumbar spine fractures.After literature screening,data extraction,and evaluation on the methodological quality of the studies included,a network Meta-analysis was carried out using WinBUGS 1.4.3 software.Results A total of 11 articles were included,involving 1477 patients and three approaches(curved approach,unilateral approach,and bilateral approach),and the 11 studies were split up and incorporated into 16 two-arm trials to carry out the analysis.The results of network Meta-analysis showed that,in terms of the Visual Analogue Scale(VAS)score,bilateral approach was superior to unilateral approach,while curved approach was superior to unilateral approach(all P<0.05),and the VAS score was presented from the best to the worst in the order of curved approach,bilateral approach and unilateral approach;in terms of operation duration,unilateral approach was superior to bilateral approach,while curved approach was superior to bilateral approach(all P<0.05),and operation duration was presented from the best to the worst in the order of curved approach,unilateral approach and bilateral approach;in terms of X-ray exposure frequency,curved approach was superior to bilateral approach(P<0.05),and X-ray exposure frequency was presented from the best to the worst in the order of curved approach,unilateral approach and bilateral approach;in terms of the leakage rate of bone cement,curved approach was better than unilateral or bilateral approach(all P<0.05),and the leakage rate of bone cement was presented in the order of curved approach,bilateral approach and unilateral approach,and ranked from the best to the w

关 键 词：胸腰椎骨折 经皮椎体成形术 椎弓根入路 单侧椎弓根入路 双侧椎弓根入路 弯角入路 有效性 安全性 网状Meta分析 

分 类 号：R683.2[医药卫生—骨科学]