肱骨干骨折后桡神经麻痹的系统评价

发布时间：2018-02-16 08:28

本文关键词： 桡神经病麻痹肱骨骨折 Meta分析　出处：《中华骨科杂志》2005年10期 　论文类型：期刊论文

【摘要】：目的采用循证医学研究方法,系统评价肱骨干骨折后桡神经麻痹(radialnervepalsy,RNP)的不同处理方法,为临床治疗决策提供证据基础。方法采用PubMed、Datastar及CochraneDatabase等互联网公共搜索引擎作为检索工具,检索过去40年中发表的有关肱骨干骨折后桡神经麻痹的文献,再对入选文献的参考文献行手工检索,制定数据抽取问表,对入选文献进行数据抽取、汇总、归纳和荟萃分析。结果共检索到391篇原始文献,其中324篇得自电子检索,67篇得自手工检索。有35篇符合最终的入选标准,总计随访患者1045例。其中21篇文献共记录了发生于4517例肱骨干骨折中的532例桡神经麻痹,肱骨干骨折后桡神经麻痹的发生率为11.8%。肱骨干中1/5和中远1/5部位的桡神经麻痹发生率明显高于其他部位(P0.05)。不同骨折类型中,横形和螺旋形骨折较斜形和粉碎性骨折更易于并发桡神经麻痹(P0.0001)。肱骨干骨折后桡神经麻痹总的恢复率为88.1%,早期保守治疗的病例自发性恢复率为70.7%。观察等待组和早期手术探查组之间神经恢复的最终结果没有明显差别。结论对肱骨干骨折后桡神经麻痹采用早期保守治疗不会影响神经的最终恢复结果,可以避免许多不必要的手术。
[Abstract]:Objective to systematically evaluate the different management methods of radial nerve palsy (RNPP) in radial nerve palsy after humeral shaft fracture, and to provide evidence basis for clinical treatment decision. Methods the online public search engines such as PubMedMedastar and CochraneDatabase were used as search tools. To retrieve the literature published in the past 40 years on radial nerve paralysis after humeral shaft fracture, and then manually search the selected references, make the data extraction table, extract and summarize the selected documents. Results A total of 391 original documents were retrieved, of which 324 were obtained from electronic retrieval and 67 from manual retrieval. 35 of them met the final selection criteria. A total of 1045 patients were followed up. Among them, 532 cases of radial nerve paralysis, which occurred in 4517 cases of humeral shaft fracture, were recorded in 21 articles. The incidence of radial nerve paralysis after humeral shaft fracture was 11.8%. The incidence of radial nerve paralysis in 1/5 and 1/5 parts of humerus trunk was significantly higher than that in other parts (P 0.05). Transverse and spiral fractures were more likely to be complicated with radial nerve palsy than oblique and comminuted fractures (P 0.0001). The total recovery rate of radial nerve paralysis after humeral shaft fracture was 88.1.The spontaneous recovery rate of early conservative treatment was 70.7. Conclusion early conservative treatment of radial nerve paralysis after humeral shaft fracture will not affect the final recovery of nerve. Many unnecessary surgeries can be avoided.
【作者单位】：复旦大学附属中山医院骨科 Department
【分类号】：R683.42

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