[1]张家媛,刘文刚,林晓东,等.止血带在关节镜下前交叉韧带重建术中应用价值的Meta分析[J].中医正骨,2022,34(05):32-37.
　ZHANG Jiayuan,LIU Wengang,LIN Xiaodong,et al.Clinical application value of tourniquets in arthroscopic anterior cruciate ligament reconstruction:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(05):32-37.
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止血带在关节镜下前交叉韧带重建术中应用价值的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年05期
页码:
32-37
栏目:
文献研究
出版日期:
2022-05-20

文章信息/Info

Title:
Clinical application value of tourniquets in arthroscopic anterior cruciate ligament reconstruction:a meta-analysis
作者:
张家媛1; 刘文刚2; 林晓东2; 陈泽华1; 卢超2; 王维熙2; 郑伟1; 单嘉欣1; 张一龙1; 黄磊1; 杨文斌2
(1.广州中医药大学第五临床医学院,广东 广州 510405; 2.广东省第二中医院,广东 广州 510095)
Author(s):
ZHANG Jiayuan1; LIU Wengang2; LIN Xiaodong2; CHEN Zehua1; LU Chao2; WANG Weixi2; ZHENG Wei1; SHAN Jiaxin1; ZHANG Yilong1; HUANG Lei1; YANG Wenbin2
1.The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China 2.The Second Traditional Chinese Medicine Hospital of Guangdong,Guangzhou 510095,Guangdong,China
关键词:
膝关节;  前交叉韧带重建术;  关节镜检查;  止血带;  专题Meta分析
Keywords:
knee joint;  anterior cruciate ligament reconstruction;  arthroscopy;  tourniquets;  Meta-analysis as topic
摘要:
目的:系统评价止血带在关节镜下前交叉韧带(anterior cruciate ligament,ACL)重建术中的应用价值。方法:应用计算机检索中国知网、维普网、万方数据库、中国生物医学文献数据库、PubMed、Embase和Cochrane Library中关于关节镜下ACL重建术中使用止血带的随机对照试验文献。试验组术中使用止血带,对照组术中不使用止血带。检索时限均为建库至2021年4月。由2名研究者根据纳入和排除标准独立进行文献筛选和数据提取,意见不一致时讨论解决。采用Cochrane手册中的偏倚风险评估工具评价文献质量,采用RevMan5.3软件对手术时间、血红蛋白减少量、术后吗啡用量、术后引流量、膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、股四头肌肌力进行Meta分析。结果:共检索到328篇文献,通过逐层筛选,最终纳入6篇文献,涉及252例患者。Meta分析结果显示,试验组和对照组患者手术时间、血红蛋白减少量、术后吗啡用量、膝关节疼痛VAS评分、股四头肌肌力的组间差异均无统计学意义[MD=-0.08,95%CI(-0.39,0.23),P=0.630; MD=-0.08,95%CI(-0.45,0.29),P=0.660; MD=2.25,95%CI(-3.52,8.02),P=0.440; MD=0.16,95%CI(-0.13,0.44),P=0.280; MD=0.04,95%CI(-0.04,0.12),P=0.310],试验组患者术后引流量多于对照组[MD=94.85,95%CI(4.10,185.59),P=0.040]。结论:现有的证据表明,止血带在关节镜下ACL重建术中无明显应用价值。
Abstract:
Objective:To systematically review the clinical application value of tourniquets in arthroscopic anterior cruciate ligament reconstruction(ACLR).Methods:All the randomized controlled trial(RCT)articles about using tourniquets in arthroscopic ACLR included from database establishing to April 2021 were retrieved from China National Knowledge Internet,Vip Database,Wanfang Database,Chinese Biomedical Literature Database,PubMed,Embase and Cochrane Library through computer.The tourniquets were used in arthroscopic ACLR in experimental group and weren't used in control group.The articles were screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria,and if any disagreement was found between them,discussion was conducted for making a final decision.The methodological quality of research in the articles was evaluated by using bias risk assessment tools recommended by Cochrane handbook,and then a Meta-analysis on operative time,hemoglobin reduction,postoperative morphine dosage,postoperative drainage volume,knee pain visual analogue scale(VAS)score and muscular strength of quadriceps femoris was conducted by using RevMan5.3 software.Results:Three hundred and twenty-eight articles were searched out.After screening,6 articles(252 patients)were included in the final analysis.The results of Meta-analysis revealed that there was no statistical difference in operative time,hemoglobin reduction,postoperative morphine dosage,knee pain VAS score and muscular strength of quadriceps femoris between experimental group and control group(MD=-0.08,95%CI(-0.39,0.23),P=0.630; MD=-0.08,95%CI(-0.45,0.29),P=0.660; MD=2.25,95%CI(-3.52,8.02),P=0.440; MD=0.16,95%CI(-0.13,0.44),P=0.280; MD=0.04,95%CI(-0.04,0.12),P=0.310),whereas the postoperative drainage volume was more in experimental group compared to control group(MD=94.85,95%CI(4.10,185.59),P=0.040).Conclusion:Available evidences suggest that the tourniquets have no apparent applied value in arthroscopic ACLR.

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(收稿日期:2021-06-04 本文编辑:吕宁)

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备注/Memo

备注/Memo:
基金项目:广州中医药大学研究生科研创新项目(A1-2606-21-429-001Z40) 通讯作者:杨文斌 E-mail:ywb2078@163.com
更新日期/Last Update: 1900-01-01