经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折远期并发症的Meta分析

发布时间：2018-03-14 04:42

  本文选题：骨质疏松　切入点：椎体压缩骨折　出处：《中国脊柱脊髓杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的:应用Meta分析评价经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的远期并发症,为临床应用提供依据。方法:计算机检索CNKI、CBM、Pub Med、The Cochrane Library(2017年第2期)、Wiley Online Library、ELSEVIER Science Direct(SDOS)数据库,检索时间均是从建库到2017年2月。收集PKP与保守治疗OVCF的相关随机对照试验(RCT)文献,经X线、CT及MRI确定诊断为胸腰椎压缩骨折;骨密度测量仪测量确定存在胸腰椎骨质疏松(T≤-2.5);年龄≥50岁,病程6个月;术后结局指标至少包括以下指标中的一项:新发椎体骨折、邻近节段椎体骨折、严重并发症、视觉模拟评分。参考Cochrane系统评价手册5.0.1提供的针对随机对照试验的评价标准对纳入文献质量进行评价。结果:共纳入5篇RCT研究,4篇为英文文献,1篇为中文文献,方法学质量评价4篇文献为4分及以上,1篇文献为3分。PKP组共计417例,保守治疗组共计458例。Meta分析结果显示,PKP组治疗后3~6个月视觉模拟评分(VAS)与保守治疗组相比有统计学意义[MD=-0.36,95%CI(-0.65,-0.07),P=0.02];在新发椎体骨折、邻近节段椎体再发骨折、严重并发症三个方面PKP组与保守治疗组无统计学差异。结论:应用PKP治疗OVCF可以降低患者疼痛VAS评分,并且不会提高新发椎体骨折、邻近节段椎体再发骨折、严重并发症的发生风险。
[Abstract]:Objective: to evaluate the long-term complications of percutaneous transluminal kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCFS) and to provide evidence for clinical application. Methods: the Cochrane Library database was searched by computer. The retrieval time was from the establishment of the database to February 2017. The literature on PKP and the randomized controlled trial of conservative treatment of OVCF were collected and diagnosed as thoracolumbar compression fractures by X-ray CT and MRI. The measurement of bone mineral density determined the existence of thoracolumbar vertebrae osteoporosis T 鈮，

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