摘要
目的对自锁髓内钉和交锁髓内钉治疗胫骨骨折的疗效进行系统评价。方法在中国期刊全文数据库(CNKI)、万方数据库以及中国科技期刊全文数据库(VIP)中,检索1990～2011年10月发表的关于自锁髓内钉和交锁髓内钉治疗胫骨骨折疗效比较的研究。采用Stata10.0统计软件对自锁髓内钉与交锁髓内钉治疗胫骨骨折的术后膝关节功能、术后并发症发生率、手术时间、术中出血量、住院时间进行Meta分析。结果通过检索得到相关文献20篇,根据纳入、排除标准最后筛选得到9篇文献,包括胫骨骨折患者762例,其中,自锁髓内钉治疗组378例,交锁髓内钉治疗组384例。Meta分析,发现自锁髓内钉和交锁髓内钉治疗胫骨骨折术后膝关节功能Johner-Wruh评分的优良率没有统计学差异(合并OR=2.075,95%CI0.781～5.512,Z=1.46,P=0.143)。然而,自锁髓内钉治疗胫骨骨折的术后并发症发生率显著地低于交锁髓内钉组(合并OR=0.168,95%CI0.082～0.344,Z=4.87,P<0.001)。此外,自锁髓内钉组患者的手术时间、术中出血量以及住院时间均显著地少于交锁髓内钉组。结论虽然两种方法治疗胫骨骨折的术后膝关节功能恢复基本一致,但与交锁髓内钉相比,自锁髓内钉在其他安全性指标方面具有显著的优势,有较好的临床应用前景。但在临床治疗过程中,仍需综合分析患者情况,进行治疗方法的选择。
Objective To systematically compare the therapeutical effects of self-locking intramedullary nail and inter-locking intramedullary nail on tibia fracture.Methods This study retrieved the literatures from CNKI,WanFang,VIP database between 1990 and Oct.2011.Meta-analysis on the rate of excellent and good results,incidence of the complication,operation time,blood loss,and hospital stays were performed by Stata 10.0.Results 20 literatures were searched.Among them,9 literatures were selected in the following meta-analysis,including 762 tibia fracture patients.Among these patients,378 were included in self-locking intramedullary nail group and 384 were in inter-locking intramedullary nail group.The rate of excellent and good results was not statistically significant between two groups(combined OR=2.075,95% CI 0.781-5.512,Z=1.46,P=0.143).However,the incidence of the complication of self-locking intramedullary nail group was significantly lower than inter-locking intramedullary nail group(combined OR=0.168,95% CI 0.082-0.344,Z=4.87,P<0.001).Furthermore,other effective indexes of self-locking intramedullary nail group were superior to inter-locking intramedullary nail group.Conclusions Although the rate of excellent and good results between two groups was not significant,compared with inter-locking intramedullary nail,self-locking intramedullary nail group showed the significant advantages in the treatment of tibia fracture,which should be widely applied in clinical.However,it′s necessary to synthetically analyze individual situation for the selection of therapeutic methods.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第16期4768-4772,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
胫骨骨折
META分析
自锁髓内钉
交锁髓内钉
Tibia fractures
Meta-analysis
Self-locking intramedullary nail
Inter-locking intramedullary nail
