PFNA与Gamma3钉内固定治疗中老年股骨转子间骨折疗效的Meta分析

发布时间：2018-06-16 12:57

本文选题：股骨转子间骨折 + 中老年人　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：目的:对防旋型股骨近端髓内钉(PFNA)与Gamma3型髓内钉治疗中老年股骨转子间骨折治疗疗效进行meta分析。方法:运用计算机检索Pubmed、Cochrane图书馆数据库、AO/ASIF数据库、相关期刊论文(CNKI)、万方数据库、维普数据库(VIP)等,手工检索与骨科相关的会议论文等。收集PFNA与Gamma3钉治疗中老年人股骨转子间骨折的随机对照研究(Randomized Controlled Trial,RCT)和回顾性队列研究(Retrospective Cohort Study,RCS)。依据纳入与排除符合选取要求的文献、提取相关数据。选取手术时间、术中失血量、下床负重时间、术后TAD值、切口长度、Harris评分优良率、骨折愈合时间、术后并发症作为Meta分析评价指标,使用Cochrane制作的Review Manager 5.3进行Meta分析。结果:共有12篇文献纳入研究Meta分析结果,共1382例患者,其中PFNA内固定727例,Gamma3钉内固定655例。与Gamma3型钉组相比,PFNA组具有手术时间短、出血量少、术后TAD值小,但两者在住院时间、骨折愈合时间、髋关节功能Harris评分、术后优良率及并发症等方面比较,差异无显著统计学意义(P0.05)。结论:所检索的文献表明PFNA内固定较Gamma3型钉内固定治疗中老年股骨转子间骨折能有效缩短手术时间、减少术中失血量、术后TAD值,但在住院时间、骨折愈合时间、髋关节Harris评分、术后优良率及并发症方面差异不存在统计学意义。
[Abstract]:Objective: to evaluate the efficacy of anti-rotation intramedullary nailing (PFNA) and Gamma3 type intramedullary nail in the treatment of intertrochanteric fractures of the femur. Methods: the online database of Pubmedan Cochrane Library (AOP / Asif), the full text Database of Chinese Journals (CNKII), Wanfang Database and Weip Database were searched by computer, and the related conference papers of orthopedics were searched by hand. A randomized controlled RCT study of PFNA and Gamma3 nail for the treatment of femoral intertrochanteric fractures in the elderly and retrospective cohort study was conducted. According to the inclusion and exclusion of the selected documents, extract the relevant data. The operative time, blood loss, weight loading time, TAD value, incision length and Harris score, fracture healing time and postoperative complications were selected as Meta-analysis index. Cochrane's Review Manager 5.3 was used for Meta-analysis. Results: a total of 12 literatures were included in the Meta-analysis of 1382 patients, including 727 cases of internal fixation with Gamma3 nail and 655 cases with internal fixation of Gamma3 nail. Compared with Gamma3 nail group, PFNA group had shorter operation time, less bleeding and lower TAD value after operation. However, the hospitalization time, fracture healing time, Harris score of hip function, postoperative excellent and good rate and complications were compared between PFNA group and Gamma3 nail group. The difference was not significant (P 0.05). Conclusion: compared with Gamma3 nail internal fixation, PFNA can effectively shorten the operation time, reduce the amount of blood loss during operation and the TAD value after operation, but the time of hospitalization and fracture healing can be improved by using PFNA in the treatment of intertrochanteric fracture of femur. There was no significant difference in Harris score, excellent and good rate and complications.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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