骨盆截骨术治疗Perthes病预后的meta分析

发布时间：2018-09-05 09:57

【摘要】：目的系统评价骨盆截骨术治疗Perthes病,揭示预后特征,为科学评价骨盆截骨术提供依据。方法检索Pubmed、Embase、Cochrane library、Web of science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库,收集国内外骨盆截骨术治疗Perthes病的相关研究,依据美国医疗保健研究与质量局(Agency for Healthcare Research and Quality,AHRQ)对横断面研究的评价标准进行质量评价,整理提取数据,采用Meta-analyst软件进行meta分析。结果1.根据Stulberg分级评价标准,结果分析表明2-16岁的Perthes病患者行骨盆截骨术后随访2.6-15.2年,Stulberg I级的患者为19.2%,II级的患者为38.0%,III级的患者为27.5%,IV级的患者为17.2%,V级的患者为4.0%;根据Mose分级评价标准,结果分析表明2-14岁的Perthes病患者行骨盆截骨术后随访1.5-9.0年,Mose分级为“优”的患者为52.4%,“良”的患者为25.0%,“差”的患者为20.3%。2.根据Mckay髋关节功能分级评价标准,分析结果表明3-14岁的Perthes病患者行骨盆截骨术后随访1.0-6.5年,Mckay髋关节功能分级“优”的患者为88.5%,“良”的患者为9.9%,“可”的患者为3.3%,“差”的患者为0.8%。3.Meta分析不良症状(双下肢不等长、跛行、Trendelenburg征)结果表明:2-17岁的Perthes病患者行骨盆截骨术后随访2.8-15.2年,残留双下肢不等长的患者为24.1%;2-17岁行骨盆截骨术后随访2.8-6.9年残留Trendelenburg征(+)的患者为19.6%;2-17岁行骨盆截骨术后随访3.0-6.5年残留跛行的患者为40.3%。结论1.按Stulberg分级、Mose分级评价标准,骨盆截骨术后可有效缓解患者临床症状,并延迟或降低远期骨关节炎的发生率。2.按Mckay髋关节分级评价标准,骨盆截骨术对缓解髋关节疼痛、改善髋关节功能效果较好。3.Meta分析表明骨盆截骨术后残留较多的不良症状有跛行、Trendelenburg征(+)及双下肢不等长。
[Abstract]:Objective to evaluate the effect of pelvic osteotomy in the treatment of Perthes's disease, and to reveal the prognostic features, and to provide scientific basis for the evaluation of pelvic osteotomy. Methods Pubmed,Embase,Cochrane library,Web of science, Chinese biomedical literature database (CBM), (CNKI), Wanfang database and Weip database were searched to collect the relevant research of pelvic osteotomy for Perthes disease at home and abroad. According to the (Agency for Healthcare Research and Quality,AHRQ of the United States Medical Care Research and quality Bureau, the evaluation standard of cross-sectional research was evaluated, the data was collected and the meta was analyzed by Meta-analyst software. Result 1. According to the Stulberg grading criteria, the results showed that the follow-up period of 2.6-15.2 years after pelvic osteotomy in patients with Perthes's disease aged 2-16 years was 19.2g / II, 38.0g / III and 17.2g / V respectively, according to the evaluation criteria of Mose grade. The results showed that the patients with Perthes's disease aged 2 to 14 were followed up for 1.5 to 9.0 years after pelvic osteotomy. The number of patients with "excellent", "good" and "poor" patients were 52.4, 25.0 and 20.33. 2 respectively. According to Mckay hip function grading criteria, The results showed that the patients with Perthes's disease aged 3-14 were followed up 1.0-6.5 years after pelvic osteotomy for a period of 1.0-6.5 years. The scores of "excellent", "good", "can" and "poor" patients were 88.5, 9.9, 3.3 and 3.33, respectively, and those with "poor" and "poor" were analyzed for adverse symptoms by 0.8%.3.Meta. (lower limbs are unequal in length, The results of Trendelenburg's sign showed that patients with Perthes's disease aged 2 to 17 were followed up for 2.8-15.2 years after pelvic osteotomy. Patients with residual lower extremities of varying lengths were followed up for 2.8-6.9 years with residual Trendelenburg sign (2.8-6.9 years) in patients aged from 2 to 17 years. The patients with residual claudication of 3.0-6.5 years after pelvic osteotomy at the age of 19.6 and 17 years were followed up by pelvic osteotomy for 3.0-6.5 years and 40.3% of the patients were followed up after pelvic osteotomy. Conclusion 1. According to the criteria of Stulberg grade and Mose grade, pelvic osteotomy can effectively relieve the clinical symptoms and delay or reduce the incidence of long-term osteoarthritis. According to Mckay hip grading evaluation criteria, pelvic osteotomy was effective in relieving hip pain and improving hip joint function. 3. Meta-analysis showed that the most residual adverse symptoms after pelvic osteotomy were limping Trendelenburg sign and lower extremity.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R726.8

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