论文摘要
目的对Gamma钉与动力髋两种方法治疗成人股骨粗隆间骨折的疗效进行Mata评价。方法计算机检索MEDLIN E(1985～2007.10)、EMBASE(1985～2007.10)、Cochrane图书馆(2007年第3期)、Cochrane协作网肌骨创伤组试验数据库(2007.10)和中国生物医学文献数据库(1985～2007.10) ,手工检索《中华骨科杂志》(1985～2007.10)和《中华创伤骨科杂志》(创刊～2007.10) ,收集所有相关随机对照试验及半随机对照试验,且采用RevMan 4.2.10进行Meta分析。结果共纳入8个随机对照试验,1个半随机对照试验,共1751例患者,方法学质量为A级1篇,B级6篇,C级2篇。Meta分析显示,与动力髋组治疗股骨粗隆间骨折相比,Gamma钉组术中和术后股骨干骨折的发生率明显增加,[ RR= 3.28 ,95 %CI (1.39,7.73) ,P = 0.93;RR =5.47 ,95 %CI (1.98,15.13)],P = 0.97];二次手术率较高,[ RR=2.23 ,95 %CI (1.39,3.59) ,P = 0.65]。而在拉力螺钉切割出股骨头、术区深部感染发生率、血栓栓塞发生率上,两组差异无统计学意义。而平均手术时间、肢体短缩畸形发生率因文献数据原因未能做Meta分析。结论与动力髋组治疗股骨粗隆间骨折相比,Gamma钉组术中和术后股骨干骨折的发生率明显增加,二次手术率更高。但两种手术方式与拉力螺钉切割出股骨头、术区深部感染、血栓栓塞发生率及平均手术时间、肢体短缩畸形发生率等的关系,以及骨折类型、骨质疏松情况等对上述指标的影响尚需更多设计严格的大样本随机对照研究进一步研究。
论文目录
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