Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (33): 5397-5404.doi: 10.3969/j.issn.2095-4344.2346
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Zhan Fangbiao1, Xie Lizhong1, Zou Xinsen2, Long Jie1, Cheng Jun1, Zhang Xianwei3
1Department of Orthopedics, 2Intensive Care Unit, 3Department of Sleep Medicine, Three Gorges Hospital (Chongqing Three Gorges Central Hospital), Chongqing University, Chongqing 404000, China
Received:
2020-02-10
Revised:
2020-02-18
Accepted:
2020-03-18
Online:
2020-11-28
Published:
2020-10-15
Contact:
Cheng Jun, Associate chief physician, Department of Orthopedics, Three Gorges Hospital (Chongqing Three Gorges Central Hospital), Chongqing University, Chongqing 404000, China
Zhang Xianwei, Attending physician, Department of Sleep Medicine, Three Gorges Hospital (Chongqing Three Gorges Central Hospital), Chongqing University, Chongqing 404000, China
About author:
Zhan Fangbiao, Doctoral candidate, Associate chief physician, Department of Orthopedics, Three Gorges Hospital (Chongqing Three Gorges Central Hospital), Chongqing University, Chongqing 404000, China
CLC Number:
Zhan Fangbiao, Xie Lizhong, Zou Xinsen, Long Jie, Cheng Jun, Zhang Xianwei. Efficacy and safety of percutaneous kyphoplasty versus posterior short-segment fixation with vertebra augmentation for Kummell’s disease: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(33): 5397-5404.
2.1 文献检索结果分析 初步检索共得到1 256篇文献,EndNote、NoteExpress软件查重删除重复文献(n=436),依据纳入排除标准阅读标题、摘要后排除113篇,初步纳入文献23篇。经阅读全文后最终纳入4篇文献进行Meta分 析[23-26],均为已公开发表的临床对照研究,其中1篇为回顾性病例对照研究,3篇为回顾性队列研究,共200例患者,其中PKP组108例,PSF+BC组92例。文献筛选流程见图1,纳入文献基本情况见表1。由2位作者根据NOS量表分别对纳入的4篇文献进行质量评价,从病例选择、对照、结局指标3个方面进行评价,6星及以上为高质量文献,回顾性临床对照研究文献评分分别为6星1篇,7星2篇,8星1篇。 "
2.1 文献检索结果分析 初步检索共得到1 256篇文献,EndNote、NoteExpress软件查重删除重复文献(n=436),依据纳入排除标准阅读标题、摘要后排除113篇,初步纳入文献23篇。经阅读全文后最终纳入4篇文献进行Meta分 析[23-26],均为已公开发表的临床对照研究,其中1篇为回顾性病例对照研究,3篇为回顾性队列研究,共200例患者,其中PKP组108例,PSF+BC组92例。文献筛选流程见图1,纳入文献基本情况见表1。由2位作者根据NOS量表分别对纳入的4篇文献进行质量评价,从病例选择、对照、结局指标3个方面进行评价,6星及以上为高质量文献,回顾性临床对照研究文献评分分别为6星1篇,7星2篇,8星1篇。 "
2.2.5 目测类比评分 纳入的4篇文献中3篇详细比较了术前及末次随访目测类比评分[23-24,26]。文献间术前目测类比评分无异质性(Chi2=3.16,df=2,I2=37%,P=0.21),选择固定效应模型进行Meta分析;文献间术后末次随访目测类比评分有异质性(Chi2=4.24,df=2,I2=53%,P=0.12),选择随机效应模型进行Meta分析。两组术前与术后末次随访的目测类比评分比较差异均无显著性意义[MD=0.13,95%CI(-0.21,0.47),Z=0.73,P=0.46;MD=-0.10,95%CI(-0.43,0.23),Z=0.41,P=0.68],见图6。 "
2.2.6 Oswestry功能障碍指数评分 纳入的4篇文献中3篇详细比较了术前及术后末次随访Oswestry功能障碍指数评分[23-25]。文献间术前Oswestry功能障碍指数评分无异质性(Chi2=2.82,df=2,I2=29%,P=0.24),选择固定效应模型进行Meta分析。两组术前Oswestry功能障碍指数评分比较差异无显著性意义[MD=0.07,95%CI(-1.67, 1.81),Z=0.08,P=0.94],见图7A。因考虑到DUAN等[25]报道的Oswestry功能障碍指数末次随访时间为6个月,而HUANG等[23]和LI等[24]报道的Oswestry功能障碍指数术后末次随访时间为24个月左右,若纳入DUAN等报道的Oswestry功能障碍指数进行Meta分析可能结果不可靠,故纳入2篇文献进行亚组分析[23-24]。文献间术后末次随访Oswestry功能障碍指数评分无异质性(Chi2=0.00,df=1,I2=0%,P=0.97),选择随机固定模型进行Meta分析。两组末次随访的Oswestry功能障碍指数评分比较差异无显著性意义[MD=1.28,95%CI(-0.82,3.37),Z=1.19,P=0.23],见图7B。 "
2.2.7 局部后凸角 纳入的4篇文献均详细比较了术前局部后凸角[23-26],文献间无异质性(Chi2=1.40,df=3,I2=0%,P=0.70),选择固定效应模型进行Meta分析。两组术前的局部后凸角比较差异无显著性意义[MD=-0.22,95%CI(-0.76, 0.31),Z=0.83,P=0.41],见图8A。纳入的4篇文献中本3篇比较了术后即刻局部后凸角[23-25],文献间无异质性(Chi2=0.54,df=2,I2=0%,P=0.76),选择固定效应模型进行Meta分析。两组术后即刻的局部后凸角比较差异无显著性意义[MD=0.24,95%CI(-0.58,1.06),Z=0.58,P=0.56],见图8B。纳入的4篇文献中3篇比较了术后末次随访局部后凸角[23-24,26],文献间无异质性(Chi2=1.62,df=2,I2=0%,P=0.45),选择固定效应模型进行Meta分析。两组术后末次随访的局部后凸角比较差异无显著性意义[MD=0.28,95%CI(-1.28,1.84),Z=0.35,P=0.72],见图8C。 "
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