机器人辅助骶髂螺钉内固定治疗骨盆后环骨折临床疗效的meta分析  

The clinical efficacy of robot-assisted internal fixation with sacroiliac screws for posterior pelvic ring fractures: a meta-analysis

作　　者：刘志 印国庆 赵树山[1] 赵瑞波[1] 龙海涛[1] 成亮[1] 卢邦宝[1] 孙步华 曾敏[1] 陈灿[1] 朱勇[1] 林涨源[1] Liu Zhi;Yin Guoqing;Zhao Shushan;Zhao Ruibo;Long Haitao;Cheng Liang;Lu Bangbao;Sun Buhua;Zeng Ming;Chen Can;Zhu Yong;Lin Zhangyuan(Department of Orthopaedics,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Spinal Surgery,Xiangya Boai Rehabilitation Hospital,Changsha 410100,China)

机构地区：[1]中南大学湘雅医院骨科,长沙410008 [2]湘雅博爱康复医院脊柱外科,长沙410100

出　　处：《中华骨科杂志》2023年第19期1324-1333,共10页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金(81902222);湖南省自然科学基金(2020JJ4928)。

摘　　要：目的比较机器人辅助与透视辅助骶髂螺钉内固定治疗骨盆后环骨折的临床疗效。方法检索中国知网、万方、中华医学期刊全文数据库、PubMed、Web of Science和ScienceDirect等关于机器人辅助与透视辅助骶髂螺钉内固定治疗骨盆后环骨折的文献。检索时间为各数据库建立至2023年3月。对纳入文献进行meta分析。组间异质性较大时采用随机效应模型进行分析,组间异质性较小时采用固定效应模型进行分析。结果共15篇文献纳入meta分析,机器人辅助组465例、透视辅助组396例。Meta分析结果显示机器人辅助组的透视次数[SMD=-3.12,95%CI(-4.34,-1.89),P<0.001]、导针调整次数[SMD=-3.75,95%CI(-6.77,-0.72),P=0.015]、术中出血量[SMD=-0.83,95%CI(-1.18,-0.49),P<0.001]、手术时间[SMD=-2.59,95%CI(-4.11,-1.08),P<0.001]均小于透视辅助组;螺钉位置的优良率[OR=10.13,95%CI(3.67,27.98),P<0.001]大于透视辅助组;两组Majeed功能评分[SMD=0.28,95%CI(-0.0003,0.55),P=0.050]和骨折愈合时间[SMD=-0.14,95%CI(-0.46,0.17),P=0.367]的差异无统计学意义。结论机器人辅助经皮骶髂螺钉内固定治疗骨盆后环骨折具有透视次数少、导针调整次数少、术中出血量少、手术时间短、螺钉位置优良率高的优势,但在Majeed评分和骨折愈合时间方面与透视辅助相比无差异。Objective To compare the clinical efficacy of robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures.Methods China National Knowledge Infrastructure(CNKI),Wanfang Data,Chinese Medical Journal Full-text Database,PubMed,Web of Science and ScienceDirect were searched for literature on robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures.The search time was from the establishment of each database to March 2023.Meta-analysis was performed on the included literature.The random-effects model was used when the heterogeneity between groups was large,and the fixed-effects model was used when the heterogeneity between groups was small.Results A total of 15 studies were included in the meta-analysis,including 465 patients in the robot-assisted group and 396 patients in the fluoroscopy-assisted group.Meta-analysis showed that the number of fluoroscopies[SMD=-3.12,95%CI(-4.34,-1.89),P<0.001],the number of guide pin adjustments[SMD=-3.75,95%CI(-6.77,-0.72),P=0.015],intraoperative blood loss[SMD=-0.83,95%CI(-1.18,-0.49),P<0.001],and operative time[SMD=-2.59,95%CI(-4.11,-1.08),P<0.001]were smaller than those in the fluoroscopy-assisted group.The rate of excellent screw implantation[OR=10.13,95%CI(3.67,27.98),P<0.001]of the robot-assisted was larger than the fluoroscopy-assisted group.There was no significant difference in Majeed functional score[SMD=0.28,95%CI(-0.0003,0.55),P=0.050]and fracture healing time[SMD=-0.14,95%CI(-0.46,0.17),P=0.367]between the two groups.Conclusion Robot-assisted percutaneous sacroiliac screw fixation for posterior pelvic ring fractures has the advantages of less fluoroscopy,less guide pin adjustment,less intraoperative blood loss,shorter operation time,and higher rate of excellent screw position.However,there is no difference in Majeed score and fracture healing time between robot-assisted percutaneous sacroiliac screw fixation and fluoroscopy-assisted percutaneous sacroiliac screw f

关 键 词：骨盆 骨折 机器人 骨折固定术 内 META分析 

分 类 号：R687.3[医药卫生—骨科学]