三种不同手术方式治疗肱骨干骨折的网络Meta分析

发布时间：2018-07-10 06:50

本文选题：肱骨干骨折 + 微创钢板内固定　；参考：《重庆医科大学学报》2017年02期

【摘要】：目的:比较三种不同手术方式治疗肱骨干骨折的临床疗效。方法:计算机检索Cochrane Library、Pub Med、Embase、OVID、CBM、CNKI、万方和维普数据库中相关的随机对照试验(randomized controlled trials,RCTs),检索时限均为建库至2015年11月。2名评价者按纳入排除标准对文献进行独立筛选,并根据"Cochrane协作网的偏倚风险评估标准"对纳入文献进行质量评价。纳入文献的质量评价通过Rev Man 5.3软件完成,采用Win BUGS 1.4.3和Stata 13.0软件进行网络Meta分析。结果:最终纳入16篇RCTs,共744例患者。网络Meta分析结果显示:微创钢板内固定(minimally invasive plate osteosynthesis,MIPO)的桡神经损伤率最低(SUCRA值:77.1%),其次为髓内钉(intramedullary nailing,IMN)(SUCRA值:44.2%),切开复位钢板内固定(open reduction and plate osteosynthesis,ORPO)最高(SUCRA值:28.7%)。MIPO发生骨折不愈合的可能性最低(SUCRA值:71.9%),ORPO次之(SUCRA值:50.4%),IMN则最高(SUCRA值:27.7%)。IMN发生感染的几率最低(SUCRA值:74.0%),其次为MIPO(SUCRA值:63.3%),ORPO最高(SUCRA值:12.7%)。结论:目前证据表明手术治疗肱骨干骨折,MIPO可能为最优选择,ORPO相比IMN则更有优势。
[Abstract]:Objective: to compare the clinical effects of three different surgical methods in the treatment of humeral shaft fracture. Methods: a computerized search was conducted for the Cochrane Library Pub Medbase OVIDN CBMN CNKI (randomized controlled trialsrcts) in Wanfang and Wiper databases. The time limit for retrieval was from the establishment of the library to November 2015, when the literature was independently screened according to the inclusion exclusion criteria. The quality of the literature was evaluated according to the criteria of bias risk assessment of Cochrane collaboration. The quality evaluation was completed by Rev Man 5.3 software, and the network meta-analysis was carried out by WinBUGS 1.4.3 and Stata 13.0 software. Results: a total of 744 patients were included in 16 RCTs. The results of network meta-analysis showed that the radial nerve injury rate of minimally invasive plate fixation with (minimally invasive plate osteosynthesism was the lowest (SUCRA: 77.1%), followed by intramedullary nailing (sucra: 44.2%), and (open reduction and plate osteosynthesisorpo with open reduction plate was the highest (SUCRA: 28.7%). The probability of infection in IMN was the lowest (supera value: 71.9%), followed by ORPO (SUCRA value: 50.4%), IMN (SUCRA value: 27.7%), IMN (SUCRA value: 74.0%), MIPO (SUCRA value: 63.3%) and Orpo (SUCRA value: 12.7%). Conclusion: the present evidence suggests that MIPO may be the best choice for the treatment of humeral shaft fracture, and that ORPO is more superior than IMN.
【作者单位】：重庆医科大学附属永川医院骨科;
【基金】：重庆市教委自然科学基金资助项目(编号:KJ110327)
【分类号】：R687.3

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