中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (8): 1248-1257.doi: 10.3969/j.issn.2095-4344.1087

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

不同入路全髋关节置换后髋关节功能的网状Meta分析

张 驰1，吕浩源2，章晓云3，林宗汉3，陈跃平3，董盼锋3，冯 洋1   

  1. 1广西中医药大学研究生学院，广西壮族自治区南宁市   530001；2湖北中医药大学第一临床学院，湖北省武汉市   430061；3广西中医药大学附属瑞康医院骨科，广西壮族自治区南宁市   530011
  • 出版日期:2019-03-18 发布日期:2019-03-18
  • 通讯作者: 林宗汉，主任医师，硕士生导师，广西中医药大学附属瑞康医院骨科，广西壮族自治区南宁市 530011
  • 作者简介:张驰，男，1993年生，湖北省武汉市人，汉族，广西中医药大学在读硕士，主要从事骨与关节损伤及骨病研究。
  • 基金资助:

    国家自然科学基金资助项目(81760796)，项目负责人：陈跃平；广西卫生厅重点课题(S201419-05)，项目负责人：陈跃平；2017年广西中医药大学校级培育学科-骨外科学建设项目(04B2017082)，项目负责人：陈跃平

Hip function after total hip arthroplasty through different approaches: a network meta-analysis

Zhang Chi1, Lü Haoyuan2, Zhang Xiaoyun3, Lin Zonghan3, Chen Yueping3, Dong Panfeng3, Feng Yang1   

  1. 1Graduate School, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2First Clinical College, Hubei University of Chinese Medicine, Wuhan 430061, Hubei Province, China; 3Department of Orthopedics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • Online:2019-03-18 Published:2019-03-18
  • Contact: Lin Zonghan, Chief physician, Master supervisor, Department of Orthopedics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • About author:Zhang Chi, Master candidate, Graduate School, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81760796 (to CYP); the Key Project of Guangxi Health Department, No. S201419-05 (to CYP); the Discipline Training Project of Guangxi University of Chinese Medicine-Orthopedics Construction Project, No. 04B2017082 (to CYP)

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摘要：

文章快速阅读：

 
 
文题释义：
网状Meta分析：基于直接比较和间接比较结果比较多个干预措施的治疗效果，或者是在没有直接比较的情况下，分析多个干预措施之间效果差异的荟萃分析。其优势在于可以对治疗同类疾病的不同干预措施进行量化比较，并按照某一结果指标效果好坏进行排序，进而选择可能的最优治疗方案。
全髋关节置换手术入路：临床上全髋关节置换有7种常见的手术入路，分别为传统后侧入路、改良Hardinge入路、小切口后侧入路；直接前侧入路、慕尼黑骨科医院入路、SuperPATH入路及双切口入路。目前对于全髋关节置换最佳手术入路没有达成共识。
 
摘要
背景：临床上全髋关节置换术有7种常见的手术入路，分别为传统后侧入路、改良Hardinge入路、小切口后侧入路；直接前侧入路、慕尼黑骨科医院入路、SuperPATH入路及双切口入路。目前对于全髋关节置换最佳手术入路没有达成共识，暂未查阅到涵盖上述7种手术入路的系统评价。
目的：对比不同手术入路全髋关节置换后的近期、远期髋关节功能差异。
方法：计算机检索PubMed、Embase、The Cochrane Library、中国生物医学文献数据库、中国知网、万方和维普数据库，根据纳入与排除标准进行文献筛选、质量评价和数据提取后应用Stata软件、R软件对各项结局指标进行网状Meta分析。
结果与结论：①共纳入25个随机对照试验，合计2 253髋，涉及7种干预措施；②网状Meta分析结果显示，传统后侧入路的近期髋关节Harris评分低于改良Hardinge入路、直接前侧入路、慕尼黑骨科医院入路；慕尼黑骨科医院入路的近期髋关节Harris评分高于SuperPATH入路；小切口后侧入路的远期髋关节Harris评分高于其他6种手术入路；③结果提示全髋关节置换后近期髋关节Harris评分最高的手术入路可能是慕尼黑骨科医院入路，远期髋关节Harris评分最高的手术入路是小切口后侧入路，双切口入路在术后近期、远期髋关节Harris评分方面均可能作为第二优选；④上述结论仍需要大量设计合理、涵盖多种手术入路的随机对照试验予以证实。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-4143-170X(张驰)

关键词: 全髋关节置换, 直接前侧入路, 后侧入路, 改良Hardinge入路, 双切口入路, SuperPATH入路, 髋关节Harris评分, 网状Meta分析, 国家自然科学基金

Abstract:

BACKGROUND: There are seven kinds of common surgical approaches for total hip arthroplasty, including the traditional posterior approach, modified Hardinge approach, small-incision posterior approach, direct anterior approach, Orthopdische Chirurgie Munchen approach, SuperPATH approach and double incision approach. There is no consensus on the best surgical approach for total hip arthroplasty. There is a lack of systematic review of the above seven surgical approaches.

OBJECTIVE: To compare the short- and long-term hip function after total hip arthroplasty by different surgical approaches.
METHODS: PubMed, Embase, The Cochrane Library, CBM, CNKI, WanFang and VIP databases were searched. According to the inclusion and exclusion criteria, literature screening, quality evaluation and data extraction were performed. A network meta-analysis of each measurement outcome was conducted using Stata software and R software.
RESULTS AND CONCLUSION: (1) A total of 25 randomized controlled trials including 2 253 hips involving the seven interventions were included. (2) Network meta-analysis showed that the postoperative short-term Harris hip scores of the traditional posterior approach were lower than those of the modified Hardinge approach, direct anterior approach, Orthopdische Chirurgie Munchen approach. The postoperative short-term Harris hip scores of the Orthopdische Chirurgie Munchen approach were higher than those of the SuperPATH approach. The postoperative long-term Harris hip scores of the small-incision posterior approach were higher than those of the other surgical approaches. (3) These results indicate that the surgical approach with the highest postoperative short-term Harris hip scores may be the Orthopdische Chirurgie Munchen approach. The surgical approach with the highest postoperative long-term Harris hip scores is the posterior approach of the small incision. The double-incision approach in short-term and long-term Harris hip scores may be the second preference. (4) The above conclusions need to be confirmed by a large number of randomized controlled trials that are well designed and cover a variety of surgical approaches.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Randomized Controlled Trials, Meta-Analysis, Tissue Engineering

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