手术与非手术治疗移位型跟骨关节内骨折的Meta分析

发布时间：2018-01-06 03:03

本文关键词：手术与非手术治疗移位型跟骨关节内骨折的Meta分析　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:比较手术与非手术治疗移位型跟骨关节内骨折的临床疗效。方法:计算机检索Conchrane Library、Pub Med、Embase、OVID、CBM、CNKI、万方和维普数据库中关于手术与非手术治疗移位型跟骨关节内骨折的随机对照试验,检索时限为建库至2015年5月,同时查阅所获取的参考文献索引。两名研究者对检索收集到的文献按照制定的纳入排除标准进行独立筛选。采用美国骨科足与踝关节协会的踝与后足评分系统(AOFAS)、SF-36(PCS)、SF-36(MCS)、术后疼痛、并发症(浅部感染、深部感染)、距下关节融合、不能返回原工作、Bohler角作为评价指标。采用Review Manager 5.3软件进行Meta分析。结果:最终纳入7篇随机对照研究,共789例患者。Meta分析结果显示:两组患者在术后美国骨科足与踝关节协会的踝与后足评分系统(AOFAS)、SF-36(MCS)、术后疼痛和距下关节融合方面无统计学差异,在SF-36(PCS)、并发症(浅部感染、深部感染)、Bohler角及不能返回原工作方面均有统计学差异。结论:研究结果发现对于患者的远期功能和疼痛情况,手术与非手术治疗效果相似,手术治疗不能减小因距下关节炎而需进行关节融合手术的风险,不过手术能更好的恢复Bohler角及使患者返回原工作,但是手术治疗会有更高的感染风险,易导致并发症。
[Abstract]:Objective: to compare the clinical effects of surgical and non-operative treatment of displaced intra-articular calcaneal fractures. Methods: Conchrane Library Pub MedEmbase was searched by computer. A randomized controlled trial of surgical and non-operative treatment of displaced intra-articular calcaneal fractures was conducted in OVID-CBMN CNKI, Wanfang and Wiper databases. The retrieval time was until May 2015. Two researchers independently screened the collected literature according to the exclusion criteria established. The American Orthopedic foot and ankle Association's ankle and hind foot scoring system was used. AOFAS. SF-36 PCSU SF-36 MCSA, postoperative pain, complications (superficial infection, deep infection, subtalar joint fusion, can not return to the original work. Bohler angle was used as evaluation index. Meta analysis was carried out with Review Manager 5.3 software. Results: 7 randomized controlled studies were conducted. A total of 789 patients. Meta-analysis showed that the ankle and hind foot score system of American Orthopedic foot and ankle Association was AOFASA SF-36 MCSs. There was no significant difference in postoperative pain and subtalar joint fusion in SF-36 with PCS, complications (superficial infection, deep infection). There were significant differences in Bohler angle and inability to return to work. Conclusion: the results of the study showed that the effect of surgical and non-surgical treatment was similar to that of non-surgical treatment for patients with long-term function and pain. Surgical treatment does not reduce the risk of arthrodesis due to subtalar arthritis, but surgery can better restore the Bohler angle and bring the patient back to work. But surgical treatment has a higher risk of infection and can lead to complications.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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