髓内钉与外固定治疗胫腓骨骨折疗效的Meta分析

发布时间：2018-10-15 09:40

【摘要】：[目的]应用系统评价的方法比较开放性胫腓骨骨折治疗中应用交锁髓内钉与外固定的疗效,为临床实践与研究提供参考。[方法]计算机检索相关期刊论文、中文科技期刊全文数据库、万方数据库、Pubmed、Web of Science关于交锁髓内钉和外固定治疗开放性胫腓骨骨折疗效比较的研究,末次检索时间为2015年7月,选择适合本研究特点的质量评价标准对纳入文献进行质量评价,使用Stata 13.0软件进行Meta分析。[结果]通过检索得到相关文献163篇,根据纳入、排除标准最后筛选得到14篇文献,包括开放性胫腓骨骨折患者1 101例。其中,交锁髓内钉治疗组517例,外固定治疗组584例。对比交锁髓内钉和外固定治疗开放性胫腓骨骨折的愈合优良率(Johner-Wruh标准评定疗效)(OR=2.21,95%CI=1.48-3.31,P=0.0001)差异有统计学意义,而术后感染的发生率(OR=1.52,95%CI=0.91-2.55,P=0.291)、骨折愈合时间(SMD=-0.38,95%CI=-1.08-0.33,P=0.296)、术后延迟愈合或不愈合的发生率(OR=1.38 95%CI=0.79-2.44,P=0.266),术后骨不连的发生率(OR=1.22,95%CI=0.46-3.26,P=0.693),差异没有统计学意义。[结论]交锁髓内钉治疗开放性胫腓骨骨折优于外固定组。
[Abstract]:[objective] to compare the efficacy of interlocking intramedullary nail and external fixation in the treatment of open tibiofibula fracture by means of systematic evaluation, and to provide reference for clinical practice and research. [methods] A comparative study on the efficacy of interlocking intramedullary nail and external fixation in the treatment of open tibiofibula fractures was made by computer retrieval of Chinese periodical full-text database, Chinese sci-tech journal full-text database, Wanfang database and Pubmed,Web of Science. The last retrieval time was July 2015. The quality evaluation criteria suitable for the characteristics of this study were selected to evaluate the quality of the literature included, and the Meta analysis was carried out with Stata 13.0 software. [results] 163 articles were obtained by searching, and 14 articles were selected according to inclusion and exclusion criteria, including 1 101 cases of open tibiofibula fracture. Among them, 517 cases were treated with interlocking intramedullary nail and 584 cases were treated with external fixation. There were significant differences in the rate of healing between interlocking intramedullary nail and external fixation in the treatment of open tibiofibula fractures (Johner-Wruh criteria for evaluation of curative effect) (OR=2.21,95%CI=1.48-3.31,P=0.0001). There was no significant difference in the incidence of postoperative infection (OR=1.52,95%CI=0.91-2.55,P=0.291), fracture healing time (SMD=-0.38,95%CI=-1.08-0.33,P=0.296), delayed healing or nonunion (OR=1.38 95CI0.79-2.44) and the incidence of postoperative nonunion (OR=1.22,95%CI=0.46-3.26,P=0.693). [conclusion] interlocking intramedullary nail is superior to external fixation in the treatment of open tibiofibula fracture.
【作者单位】：同济大学医学院医学统计学教研室;同济大学附属同济医院骨科;同济大学附属第十人民医院骨科;
【基金】：上海市卫计委资助项目(编号:201440291)
【分类号】：R687.3

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