病灶内切除与整块切除治疗桡骨远端骨巨细胞瘤的Meta分析

发布时间：2018-04-16 06:11

本文选题：桡骨 + 骨巨细胞瘤　；参考：《中国骨伤》2016年01期

【摘要】：目的 :用Meta分析的方法对国内外已发表较高质量的有关比较病灶内切除术和整块切除术对桡骨远端骨巨细胞瘤患者术后复发率、并发症发生率和功能康复结果的临床研究进行综合定量分析,为桡骨远端骨巨细胞瘤的外科治疗模式的选择提供参考依据。方法:计算机检索Cochrane图书馆(2014年8期)、Pub Med、Ovid、Elsevier、CNKI等数据库。检索从(1970-01-01/2013-01-01)年有关病灶内切除与整块切除治疗治疗桡骨远端骨巨细胞瘤的文献,筛选出符合纳入标准的文献,并对其进行严格的质量评价。利用Cochrane协作网提供的Rev Man 5.0软件对纳入研究结果进行Meta分析,并对数据进行异质性检验。计算病灶内切除术相对整块切除术其复发及并发症发生危险的优势比(OR),评价病灶内切除术与整块切除术对桡骨远端骨巨细胞瘤患者复发及并发症发生的影响。结果 :符合纳入标准的文献7篇,总样本量163例。其中病灶内切除术组92例(PMMA n=54,骨移植n=33,非PMMA或非骨移植n=5),整块切除术组71例。病灶内切除术组骨巨细胞瘤复发率比整块切除术组高[OR=3.87,95%CI(1.42,10.53)],而在Campanacci 3级GCTs中[OR=10.12,95%CI(1.57,65.27)],病灶内切除术组并发症发生率更少[OR=0.13,95%CI(0.04,0.40)],病灶内切除术组内用PMMA与骨移植物充填病灶的复发率没有明显差异[OR=0.96,95%CI(0.26,3.56)]。通过选择用MSTS系统评价、VAS系统评价和握力计系统评价时,病灶内切除术组在功能康复结果中优于整块切除组。结论:基于有限的资料,表明整块切除术更加适合治疗桡骨远端骨巨细胞瘤,而病灶内切除术在治疗桡骨远端骨巨细胞瘤的Campanacci 1、2级比3级更加适合,病灶内切除桡骨远端骨巨细胞瘤方面,PMMA并不优于骨移植物。病灶内切除桡骨远端骨巨细胞瘤在功能康复方面优于整块切除组。
[Abstract]:Objective: to compare the recurrence rate of patients with giant cell tumor of distal radius by Meta analysis.The incidence of complications and the results of functional rehabilitation were analyzed in order to provide reference for the choice of surgical treatment mode for giant cell tumor of distal radius.Methods: the database of Cochrane Library (Pub Medsite Ovid Elsevier CNKI etc.) was searched by computer.From 1970 to 01-01 / 2013-01-01, the literature on the treatment of giant cell tumor of distal radius was selected and the quality was evaluated strictly.Using the Rev Man 5.0 software provided by the Cochrane Cooperative Network, the results of the research are analyzed by Meta, and the heterogeneity of the data is tested.To evaluate the risk of recurrence and complications in patients with giant cell tumor of distal radius.Results: there were 7 articles in accordance with the inclusion criteria, and 163 samples were collected.Among them, 92 cases were treated by intratumoral resection (n = 92), bone graft (n = 33), non PMMA or non bone graft (n = 5), and mass resection group (n = 71).The recurrence rate of giant cell tumor of bone was higher in the intrafocus resection group than in the whole resection group [OR3.8795% CI 1.42n 10.53], but in Campanacci 3 GCTs [OR10.12 95 CI1.57% 65.27], the incidence of complications was lower in the intratumoral resection group [OR0.1395CI0.04 0.40], and PMMA and bone grafts were used to fill the recurrence of the lesions in the intrafocal resection group (OR0.1395CI0.040.40).There was no significant difference in the rate [ORX 0.96 ~ 95 CI 0.26 ~ 3.56].By using MSTS system to evaluate VAS system and grip strength meter system evaluation, the results of functional rehabilitation in the lesion resection group were better than that in the whole block resection group.Conclusion: based on the limited data, the whole block resection is more suitable for the treatment of giant cell tumor of distal radius, and the intrafocal resection is more suitable for the treatment of giant cell tumor of distal radius in Campanacci grade 1 than in grade 3.PMMA is not superior to bone graft in intratumoral excision of giant cell tumor of distal radius.Intra-focal excision of giant cell tumor of distal radius was superior to the whole resection group in functional rehabilitation.
【作者单位】：宁波市第二医院骨科;宁波大学医学院;
【分类号】：R738.1

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