高黏度与普通黏度骨水泥椎体成形系统修复骨质疏松性椎体压缩性骨折的荟萃分析

发布时间：2018-03-08 21:17

本文选题：脊柱骨折　切入点：骨折　出处：《中国组织工程研究》2017年02期 　论文类型：期刊论文

【摘要】：背景:椎体成形系统修复骨质疏松性椎体压缩性骨折的疗效已得到肯定,但骨水泥渗漏导致的相关并发症仍时有发生。根据渗漏因素分析所产生的高黏度骨水泥安全性和有效性高,但缺乏大样本、高强度的证据研究。目的:系统评价高黏度与普通黏度骨水泥椎体成形系统修复椎体压缩性骨折的安全性和有效性。方法:计算机检索Pub Med、Embase、Cochrane Library、中国知网、维普及万方数据库等,检索时间均为各数据库自建库以来至2016年1月,收集关于高黏度骨水泥与普通黏度对比修复椎体压缩性骨折的随机或临床对照研究。由2名研究员根据Cochrane系统评价的方法独立对纳入研究的文献质量进行评价并提取数据,采用Rev Man 5.2软件进行数据分析。结果与结论:1纳入4个随机对照试验,6个临床对照试验;2Meta分析结果显示,与普通骨水泥相比,高黏度骨水泥在注射剂量[MD=0.17,95%CI(-0.04,0.38)]、目测类比评分[随机对照试验:MD=-0.30,95%CI(-0.72,0.11);临床对照试验:MD=-0.05,95%CI(-0.43,0.32)]以及术后椎体再骨折[OR=1.77,95%CI(0.24,12.86)]方面,差异均无显著性意义;但高黏度骨水泥组术后Oswestry功能障碍指数降低更明显[MD=-2.99,95%CI(-5.85,-0.13)],Cobb角恢复更佳[MD=-3.19,95%CI(-5.27,-1.10)],骨水泥渗漏率更低[OR=0.35,95%CI(0.24,0.51)],差异有显著性意义;3与普通黏度骨水泥相比,高黏度骨水泥椎体成形在恢复脊柱功能、生理结构以及减少渗漏方面更具优势。鉴于研究样本量小、异质性高,结论仍需大样本、高质量的随机对照试验予以论证。
[Abstract]:Background: the efficacy of vertebroplasty system in the repair of osteoporotic vertebral compression fractures has been confirmed. However, complications associated with bone cement leakage still occur from time to time. The high viscosity bone cement produced by seepage factor analysis has high safety and effectiveness, but lacks large samples. Objective: to systematically evaluate the safety and effectiveness of high viscosity and common viscosity bone cement vertebroplasty system in the repair of vertebral compression fractures. Methods: Pub Medsite Embase Cochrane Library, China knowledge Web, Wiper and Wanfang databases were searched by computer. The retrieval time is from the time since the database was built to January 2016. A randomized or clinical controlled study was collected on the repair of vertebral compression fractures with high viscosity bone cement compared with ordinary viscosity. Two researchers independently evaluated the quality of literature included in the study and extracted data according to the Cochrane system evaluation method. Rev Man 5.2 software was used to analyze the data. Results and conclusions: 1 was included in 4 randomized controlled trials. There was no significant difference in the injection dose of high viscosity bone cement (MD0.1795 CI-0.04 0.38) and visual analogy score (MD-0.3095CI-0.72CI-0.72CI-0.11 in randomized controlled trial; clinical control trial: MD-0.05 ~ 95CI-0.430.32) and the postoperative vertebral body refracture [OR1.77-95CI0.240.2412.86]. However, in the high viscosity cement group, the Oswestry dysfunction index decreased more significantly after operation [MD-2.99 ~ 95% CI-5.85 ~ 0.13] [MD-3.1995 ~ 95 CI-5.27 ~ 1.10], and the leakage rate of bone cement was lower [OR0.3595CI0.240.51]. The difference was significant compared with the normal viscosity cement. In view of the small sample size and high heterogeneity, the conclusion still needs a large sample and a high quality randomized controlled trial to prove it.
【作者单位】：广西壮族自治区人民医院骨科;
【分类号】：R687.3;R580

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