带袢钢板与锁骨钩钢板治疗肩锁关节脱位效果比较的Meta分析(1)

http://www.100md.com 2019年4月15日 《中国医药导报》 2019年第11期

     [摘要] 目的 系統评价带袢钢板与锁骨钩钢板治疗肩锁关节脱位的效果。 方法 计算机全面检索The Cochrane Library、PubMed、CNKI、Wanfang、CBM数据库(检索时间从建库至2017年11月)，由2位研究员独立完成文献筛选、质量评价和资料提取，并将提取数据采用Review Manager 5.3进行Meta分析。据据治疗方式分为带袢钢板和锁骨钩钢板组。 结果 最终33篇文献符合纳入标准，共纳入患者1718例。其中带袢钢板组825例，锁骨钩钢板组893例。Meta分析结果显示，带袢钢板组在术后肩关节功能Constant-Murley评分[WMD = 6.64，95%CI(3.70，9.57)，P < 0. 000 01]、肩关节Karlsson分级[OR = 3.92，95%CI(2.72，5.66)，P < 0.000 01]、肩关节活动度恢复[WMD = 13.85，95%CI(10.36，17.34)，P < 0. 000 01]、术中出血量[WMD = -11.38，95%CI(-18.22，-4.54)，P = 0. 001]方面均优于锁骨钩钢板组，但在手术时间[WMD = 1.28，95%CI(-4.38，6.94)，P = 0.66]方面，两组比较差异无统计学意义(P > 0.05)。 结论 与锁骨钩钢板内固定治疗肩锁关节脱位比较，带袢钢板内固定能更好地改善肩关节功能，提升肩关节活动度，减少术中出血量，是一种有效、安全的手术方式。

    [关键词] 肩锁关节脱位；带袢钢板；锁骨钩钢板；Meta分析

    [中图分类号] 687.4 [文献标识码] A [文章编号] 1673-7210(2019)04(b)-0120-06

    [Abstract] Objective To systematically evaluate the curative effect of Endobutton plate and clavicular hook plate(CHP) in the treatment of acromioclavicular joint dislocation. Methods The Cochrane Library， PubMed， CNKI and Wanfang， CBM databases were searched by computer (from the database establishment to November 2017). Two researchers independently screened literature， assessed the methodological quality of literature， and extracted data. Then Meta-analysis was performed with Review Manager 5.3， according to the treatment divided into Endobutton plate group and Clavicular hook plate group. Results In the end， 33 articles met the inclusion criteria， and a total of 1718 patients were included. Among them Endbutton plate group 825 cases， Clavicular hook place group 893 cases. The results of Meta analysis showed that Endobutton plate group were superior to Clavicular hook plate group in the shoulder-joint functional Constant-Murley score [WMD = 6.64， 95%CI (3.70， 9.57)， P < 0.000 1]， shoulder Karlsson classification [OR = 3.92， 95%CI (2.72，5.66)， P < 0.000 01]， shoulder mobility recovery [WMD = 13.85，95%CI (10.36，17.34)， P < 0.000 1]， intraoperative blood loss [WMD = 11.38， 95%CI (-18.22， -4.54)， P = 0.001]. However， there was no significant difference between the two groups in the time of operation [WMD = 1.28， 95%CI (-4.38，6.94)， P = 0.66]. Conclusion Compared with the internal fixation of clavicular hook plate in the treatment of acromioclavicular joint dislocation， the internal fixation with endobutton plate can better improve the function of shoulder joint， increase the activity of shoulder joint and reduce the intraoperative blood loss， which is an effective and safe operation the way.

    [Key words] Acromioclavicular joint dislocation； Endobutton plate； Clavicular hook plate； Meta-analysis(胡烈奎 彭力平 李媛)

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