[1]李亚楠,张起,古恩鹏.手术与非手术治疗肱骨近端骨折的Meta分析[J].中医正骨,2018,30(09):42-48.
　LI Yanan,ZHANG Qi,GU Enpeng.Comparison of operative treatment and non-operative treatment for treatment of proximal humeral fractures:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(09):42-48.
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手术与非手术治疗肱骨近端骨折的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年09期
页码:
42-48
栏目:
文献研究
出版日期:
2018-09-20

文章信息/Info

Title:
Comparison of operative treatment and non-operative treatment for treatment of proximal humeral fractures:a meta analysis
作者:
李亚楠1; 张起2; 古恩鹏2
1.天津中医药大学,天津 300380; 2.天津市滨海新区中医医院,天津 300450
Author(s):
LI Yanan1; ZHANG Qi2; GU Enpeng2
1.Tianjin University of Traditional Chinese Medicine,Tianjin 300380,China 2.Tianjin Binhai New District Hospital of Traditional Chinese Medicine,Tianjin 300450,China
关键词:
肩骨折;  肱骨骨折;  手术;  非手术治疗;  随机对照试验;  Meta分析;  系统评价
Keywords:
shoulder fractures;  humeral fractures;  operative treatment;  non-operative treatment;  randomized controlled trial;  Meta-analysis;  systematic review
摘要:
比较手术与非手术治疗肱骨近端骨折的临床疗效和安全性。方法:应用计算机检索CNKI、万方、维普、PubMed、Embase、Cochrance Lirbary建库至2018年4月国内外公开发表的手术与非手术治疗肱骨近端骨折的随机对照研究文献。由2位研究者严格按照纳入与排除标准独立筛选文献并提取资料,采用Cochrane风险偏倚评估工具进行文献方法学质量评价后,采用Review 5.3软件进行Meta分析。结果:最初检索出1212篇相关文献,通过详细阅读文章标题、摘要及全文,最终纳入9篇文献,均为英文文献。纳入研究的对象共585例,手术组288例、非手术组297例。Meta分析结果显示,2组Constant-Murley肩关节评分、远期肌肉力量评分、欧洲五维健康量表评分、肱骨头缺血性坏死发生率、骨折不愈合率、骨关节炎发生率、再手术率、神经损伤发生率、死亡率比较,组间差异均无统计学意义[WMD=-0.90,95%CI(-4.18,2.37); WMD=-1.14,95%CI(-2.83,0.54); WMD=0.02,95%CI(-0.02,0.06); RR=0.92,95%CI(0.58,1.48); RR=0.59,95%CI(0.24,1.47); RR=0.59,95%CI(0.21,1.62); RR=2.04,95%CI(1.13,3.71); RR=1.26,95%CI(0.40,3.92); RR=1.58,95%CI(0.76,3.29)],手术组的远期疼痛评分低于非手术组[WMD=1.77,95%CI(0.72,2.81)]。结论:手术与非手术治疗肱骨近端骨折,均能改善肩关节功能,提高患者生存质量,二者的安全性相当,但手术治疗在改善远期疼痛方面优于非手术治疗。
Abstract:
To compare the clinical curative effects and safety of operative treatment versus non-operative treatment for treatment of proximal humeral fractures.Methods:All the randomized controlled trial(RCT)articles about operative treatment(operative group)versus non-operative treatment(non-operative group)for treatment of proximal humeral fractures that published at home and abroad included from database establishing to April 2018 were retrieved from China national knowledge internet,WanFang Data,Vip Data,PubMed,Embase and Cochrance Lirbary through computer.The articles were screened and the information was extracted independently and strictly by two searchers according to the inclusion and exclusion criteria.The methodological quality of research in the articles was evaluated by using Cochrane risk bias assessment tools,and a Meta-analysis was conducted by using Review 5.3 software.Results:One thousand two hundred and twelve articles were searched out.After screening through reading titles,abstracts and full texts of the articles in detail,9 English articles(585 patients)were included in the final analysis,288 patients in operative group and 297 patients in non-operative group.The results of Meta-analysis demonstrated that there was no statistical difference in Constant-Murley shoulder scores,long-term muscle strength scores,European quality of life 5-dimensions(EQ-5D)scores and the incidence rate of ischemic necrosis of humeral head,fracture nonunion,osteoarthritis,reoperation,nerve injuries and death between the 2 groups(WMD=-0.90,95%CI(-4.18,2.37); WMD=-1.14,95%CI(-2.83,0.54); WMD=0.02,95%CI(-0.02,0.06); RR=0.92,95%CI(0.58,1.48); RR=0.59,95%CI(0.24,1.47); RR=0.59,95%CI(0.21,1.62); RR=2.04,95%CI(1.13,3.71); RR=1.26,95%CI(0.40,3.92); RR=1.58,95%CI(0.76,3.29)).The long-term pain scores were lower in operative group compared to non-operative group(WMD=1.77,95%CI(0.72,2.81)).Conclusion:Both operative treatment and non-operative treatment can effectively improve patient's shoulder function and life quality in treatment of proximal humeral fractures.They are similar to each other in safety,however,the former surpasses the latter in improving the long-term pain.

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备注/Memo

备注/Memo:
基金项目:天津市卫生和计划生育委员会中医、中西医结合科研课题(2017097) 通讯作者:古恩鹏 E-mail:guenpeng1967@163.com
更新日期/Last Update: 2018-09-20