关节镜肩袖修补术后快速康复与延迟康复的Meta分析

发布时间：2018-12-26 18:03

【摘要】：目的:比较关节镜肩袖修补术后快速康复与延迟康复的疗效与安全性。方法:计算机系统检索Pubmed、EMBASE、Cochrane library、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库、维普数据库等,及手工查找关于比较关节镜肩袖修补术后快速康复与延迟康复临床结果的随机对照研究。按照文献纳入标准、排除标准选取文献,并提取相关数据,评价研究方法学质量,采用Review Manager5.3软件对提取的数据进行统计学分析。结果:共纳入文献7篇,均为随机对照研究,包括547名患者,其中快速康复组279名,延迟康复组268名。Meta分析结果显示:快速康复组术后6个月肩关节前屈活动角度[MD=4.90,95%CI(1.98,7.82),P=0.001]大于延迟康复组,两组在术后6个月肩关节外旋活动度、ASES评分、Constant评分、VAS评分及术后12个月肩关节前屈活动度、外旋活动度、ASES评分、Constant评分、VAS评分等方面差异无统计学意义(P0.05)。在肩袖愈合方面,两康复组肩袖中小全层撕裂与中大全层撕裂修补术后肩袖愈合率及再撕裂率差异无统计学意义(P0.05)。结论:关节镜肩袖修补术后快速康复能促进早期肩关节前屈活动度恢复,但并不能明显促进肩关节功能恢复,而两组术后无论是中小撕裂还是中大撕裂,肩袖愈合率及再撕裂率没有显著差异。
[Abstract]:Objective: to compare the efficacy and safety of rapid and delayed rehabilitation after arthroscopic rotator cuff repair. Methods: Pubmed,EMBASE,Cochrane library, Chinese biomedical literature database, (CBM), (CNKI), Wanfang database, Weip database, etc., were searched by computer system. A randomized controlled study was conducted to compare the clinical results of rapid and delayed rehabilitation after arthroscopic rotator cuff repair. According to the standard of literature inclusion, the exclusion criteria were selected, and the relevant data were extracted, the quality of the research methodology was evaluated, and the extracted data were analyzed statistically by Review Manager5.3 software. Results: a total of 7 articles were included, all of which were randomized controlled trials, including 547 patients, among whom 279 were in the rapid rehabilitation group. The results of Meta analysis showed that the angle of shoulder flexion activity [MD=4.90,95%CI (1.98 卤7.82), P0. 001] in the rapid rehabilitation group was higher than that in the delayed rehabilitation group at 6 months after operation. There was no significant difference between the two groups in terms of shoulder pronation activity, ASES score, Constant score, VAS score and 12 months postoperation shoulder flexion activity, external rotation activity, ASES score, Constant score, VAS score and so on (P0.05). In the area of rotator cuff healing, there was no significant difference in the healing rate and retearing rate of rotator cuff between the two groups (P0.05). Conclusion: the rapid recovery after arthroscopic rotator cuff repair can promote the recovery of early shoulder flexion, but it can not obviously promote the recovery of shoulder function. There was no significant difference in rotator cuff healing rate and retearing rate.
【作者单位】：安徽医科大学第一附属医院运动创伤与关节镜外科;
【分类号】：R687.4

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