[1]彭德强,王思雨,李健,等.关节镜手术联合玻璃酸钠注射治疗半月板损伤的Meta分析[J].中医正骨,2022,34(11):18-26.
　PENG Deqiang,WANG Siyu,LI Jian,et al.Arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(11):18-26.
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关节镜手术联合玻璃酸钠注射治疗半月板损伤的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11期
页码:
18-26
栏目:
文献研究
出版日期:
2022-11-11

文章信息/Info

Title:
Arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury:a meta-analysis
作者:
彭德强1; 王思雨2; 李健1; 杨美平1; 牛维3
(1.广州中医药大学第二临床医学院,广东 广州 510405; 2.湖南中医药大学,湖南 长沙 410208; 3.广东省中医院,广东 广州 510120)
Author(s):
PENG Deqiang1; WANG Siyu2; LI Jian1; YANG Meiping1; NIU Wei3
1.The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China2.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China3.Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,Guangdong,China
关键词:
膝损伤;  半月板;  关节镜检查;  透明质酸;  专题Meta分析
Keywords:
knee injuries;  meniscus;  arthroscopy;  hyaluronic acid;  Meta-analysis as topic
摘要:
目的:评价关节镜手术联合玻璃酸钠注射治疗半月板损伤的临床疗效和安全性。方法:计算机检索中国知网、维普网、万方数据库、PubMed、Embase、Cochrane Library中关于关节镜手术联合玻璃酸钠注射治疗半月板损伤的临床随机对照研究文献,检索时限为建库至2021年4月,联合组干预措施为关节镜手术联合术后关节腔内玻璃酸钠注射,对照组干预措施为单纯关节镜手术。由2名研究者独立根据文献纳排标准筛选文献,并提取第一作者姓名、文献发表年份、研究样本量、研究对象性别、结局指标等数据。结局指标包括治疗有效率、Lysholm膝关节评分、膝关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、膝关节活动度、国际膝关节文献委员会(International Knee Documentation Committee,IKDC)膝关节评分、不良反应发生率、患者满意度。采用Cochrane偏倚风险评估工具对纳入文献进行质量评价,采用RevMan5.3软件对数据进行统计分析。结果:经过筛选最终纳入文献25篇,其中中文文献21篇、英文文献4篇。Meta分析结果示,联合组的治疗有效率、Lysholm膝关节评分、患者满意度均高于对照组[OR=5.63,95%CI(3.72,8.52),P=0.000; MD=11.39,95%CI(10.46,12.32),P=0.000; OR=3.94,95%CI(1.61,9.60),P=0.003]; 联合组的膝关节活动度优于对照组[MD=12.31,95%CI(11.52,13.10),P=0.000]; 联合组的膝关节疼痛VAS评分、不良反应发生率均低于对照组[MD=-0.69,95%CI(-0.87,-0.52),P=0.000; OR=0.47,95%CI(0.26,0.86),P=0.010]; 2组IKDC膝关节评分的差异无统计学意义[MD=6.27,95%CI(-10.72,23.26),P=0.470]。结论:关节镜手术联合玻璃酸钠注射治疗半月板损伤,与单纯关节镜手术相比,在缓解术后疼痛和促进膝关节功能恢复方面更有优势,综合疗效更好,安全性更高,患者更满意。
Abstract:
Objective:To evaluate the clinical efficacy and safety of arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury.Methods:All the randomized controlled trial(RCT)articles about arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury included from database establishing to April,2021 were retrieved from the China National Knowledge Internet,Vip Database,Wanfang Database,PubMed,Embase and Cochrane Library through computer.The patients in combined group were treated with arthroscopic surgery and postoperative intra-articular hyaluronic acid injection,while the ones in control group with arthroscopic surgery alone.The articles were screened by two researchers independently according to the inclusion and exclusion criteria.The first author's name,publication year,sample size,gender of subjects,outcome indicators and other data was extracted.Outcome measures included effective rate,Lysholm knee score,knee pain visual analogue scale(VAS)score,knee range of motion,International Knee Documentation Committee(IKDC)score,incidence of adverse effects,patient satisfaction.The quality of the included articles was evaluated by using Cochrane bias risk assessment tool and then a Meta-analysis was conducted by using RevMan 5.3 software.Results:After screening,25 articles were included,including 21 Chinese articles and 4 English articles.The results of meta-analysis revealed that the effective rate,Lysholm knee scores and patient satisfaction were higher in combined group compared to control group(OR=5.63,95%CI(3.72,8.52),P=0.000; MD=11.39,95%CI(10.46,12.32),P=0.000; OR=3.94,95%CI(1.61,9.60),P=0.003).The knee range of motion was better in combined group compared to control group(MD=12.31,95%CI(11.52,13.10),P=0.000).The VAS scores and incidence of adverse effects were lower in combined group compared to control group(MD=-0.69,95%CI(-0.87,-0.52),P=0.000; OR=0.47,95%CI(0.26,0.86),P=0.010).There was no statistical difference in IKDC scores between the 2 groups(MD=6.27,95%CI(-10.72,23.26),P=0.470).Conclusion:Arthroscopic surgery combined with hyaluronic acid injection in treatment of meniscus injury displays advantages as more likely to alleviate postoperative knee pain and promote the recovery of knee function,better comprehensive efficacy,higher safety and patient satisfaction compared to arthroscopic surgery alone.

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(收稿日期:2022-01-05 本文编辑:杨雅)

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更新日期/Last Update: 1900-01-01