表面髋关节置换与全髋关节置换治疗骨关节炎的系统评价

发布时间：2018-12-10 16:15

【摘要】：目的:对表面髋关节置换(HRA)与全髋关节置换(THA)治疗骨关节炎的疗效进行系统评价。比较两种术式的差异,以更好的指导临床工作。方法:计算机检索MEDLINE、EMBASE、Cochrane协作网数据库,检索时间为数据库建立到2016年6月。国内骨科杂志和有关会议资料采用人工方法检索。挑选有关的随机对照试验文献,用Cochrane协作网提供的Review Manager 5.3软件进行文献质量评价和数据统计分析。结果:共纳入8文献,总共720例病人中有355人接受表面髋关节置换术,另外365人接受全髋关节置换术。Meta分析结果:HRA组与THA组病人在术后1年WOMAC疼痛评分差异有统计学意义[MD=-1.98,95%CI(-3.74,-0.22),P=0.03],HRA组低于THA组;术后6个月、2年、5年的评分无明显差异(P0.05)。THA组术后6个月的SF-36生活质量评分较HRA组高,其余随访时间段内无明显差异。两组在术后Harris功能评分、翻修率和术后并发症发生率差异无统计学意义(P0.05);与HRA组对比,THA组手术时间更短(P0.0001)、出血更少(P=0.02)。结论:HRA在术后1年的疼痛评分方面稍占优势,THA术后6个月的生活质量评分优于HRA,但在其他随访时间段内两组无明显差异。两组术后的功能评分、翻修率和并发症发生率差异无统计学意义。HRA手术时间和手术出血较THA多。
[Abstract]:Objective: to evaluate the efficacy of surface hip replacement (HRA) and total hip replacement (THA) in the treatment of osteoarthritis. To compare the differences between the two surgical methods and to guide the clinical work better. Methods: the database of MEDLINE,EMBASE,Cochrane collaboration network was searched by computer, and the retrieval time was established until June 2016. Domestic orthopedic journals and related conference materials were retrieved manually. The literature of the randomized controlled trial was selected and the literature quality evaluation and data statistical analysis were carried out with the Review Manager 5.3 software provided by the Cochrane Cooperative Network. Results: a total of 8 literatures were included. 355 of 720 patients underwent superficial hip replacement. The results of Meta analysis showed that there was a significant difference in WOMAC pain score between HRA group and THA group one year after operation [MD=-1.98,95%CI (-3.74 卤0.22), P < 0.03], HRA group was lower than THA group. There was no significant difference in the scores of 6 months, 2 years and 5 years after operation (P0.05) the SF-36 quality of life in the). THA group was higher than that in the HRA group, and there was no significant difference in the other follow-up periods. There was no significant difference in Harris functional score, revision rate and postoperative complications between the two groups (P0.05); compared with HRA group, THA group had shorter operation time (P0.0001) and less bleeding (P0. 02). Conclusion: HRA has a slight advantage in pain score in one year after operation. The quality of life score of THA at 6 months after operation is better than that of HRA, but there is no significant difference between the two groups in other follow-up periods. There was no significant difference in functional score, revision rate and complication rate between the two groups. The operative time and bleeding in HRA were more than those in THA.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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