植骨与非植骨治疗移位型跟骨关节内骨折疗效比较的Meta分析

发布时间：2018-05-15 19:22

本文选题：跟骨骨折 + 关节内　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:本课题采用Cochrane协作网推荐的Mata分析方法对植骨与非植骨治疗移位型跟骨关节内骨折的随机对照试验进行系统评价,旨在比较移位型跟骨关节内骨折术中植骨与否对治疗效果的影响,以期为临床跟骨骨折治疗方法的选择提供理论依据。方法:计算机检索Pub Med(1954~2015.3)、EMbase(1954~2015.3)、The Cochrane Library、CNKI(1979~2015.3)、VIP(1989~2015.3)、CBM(1954~2015.3)和Wan Fang Data(1998~2015.3)等,查找对移位型跟骨关节内骨折术中植骨与不植骨进行疗效比较的随机对照试验及病例对照研究。按照Cochrane协作网的标准,由2名评价者依据事先制定的纳入和排除标准独立筛选文献。对纳入的研究进行质量评价、提取数据、资料,采用Rev Man 5.2版软件对有效数据进行Meta分析。结果:最终共纳入16篇文献,16个临床研究,1299例患者,其中植骨组769例,未植骨组530例。Meta分析结果显示:在所有结局指标中,足功能优良率[OR=2.12,95%CI(1.57,2.86),P0.00001],B?hler角丢失[MD=-2.66,95%CI(-3.04,-2.27),P0.00001],植骨组优于未植骨组;Gissane角丢失[SMD=-0.39,95%CI(-1.39,0.61),P=0.45]、跟骨高度降低[MD=-0.53,95%CI(-2.19,1.14),P=0.54],植骨组与未植骨组间差异无统计学意义。结论:对于移位型跟骨关节内骨折患者术中给予骨移植能够提高患者术后足功能优良率,从而改善患者的生活质量。
[Abstract]:Objective: to evaluate the randomized controlled trial of displaced intra-articular calcaneal fractures with or without bone graft by using the Mata analysis method recommended by Cochrane Cooperative Network in the treatment of displaced intra-articular calcaneal fractures. The purpose of this study was to compare the effect of intraarticular calcaneal fracture with or without bone graft in order to provide a theoretical basis for the treatment of calcaneal fracture. Methods: Pub Medal was searched by computer for the results of randomized controlled trial and case control study on the effect of bone grafts in displaced and intra-articular fractures during bone grafting and non-bone grafting during the operation of displaced and intra-articular fractures. The results were compared with those of the patients with displaced intraarticular fractures. The results were compared with those of the patients without bone grafts during the operation of the displaced type of bone fractures. The results were compared with those of the patients without bone graft during the operation of the displaced type of intra-articular fractures. The results were compared with those of the two groups. According to the standards of Cochrane collaboration, two reviewers independently sift the literature according to the pre-established inclusion and exclusion criteria. The quality of the included research was evaluated, the data was extracted, and the effective data was analyzed by Meta with Rev Man 5.2 software. Results: a total of 16 articles were included, 16 clinical studies were conducted in 1299 patients, including 769 cases in the bone graft group and 530 cases in the ungrafted group. The results of meta-analysis showed that: among all the outcome indicators, The excellent and good rate of foot function [OR2.1295CII 1.572.86 / P0.00001] the loss of BHler angle [MD-2.66-95CI-3.04CI-2.27CI-P0.00001], the bone graft group was superior to the non-grafted group in Gissane angle loss [SMD-0.399CI-1.399CI-1.390.661P0.45], the calcaneal height decreased [MD-0.5395CI-2.19395CI-2.191.14Pnu 0.54], there was no significant difference between the bone graft group and the non-grafted group. Conclusion: for the patients with displaced intra-articular calcaneal fracture, bone transplantation during operation can improve the excellent and good rate of postoperative foot function and improve the quality of life of the patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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