| 局限性EnnekingⅡ期骨肉瘤患者保肢与截肢治疗疗效的Meta分析 |
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投稿时间：2016-01-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 尹振春 |
YIN Zhen-chen |
宁波市第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
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| 刘丙根 |
LIU Bing-gen |
宁波市第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
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| 庞清江 |
PANG Qing-jiang |
宁波市第二医院骨科, 浙江 宁波 315010 |
Department of Orthopaedics, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
pqjey@sina.com |
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| 期刊信息：《中国骨伤》2016年，第29卷，第12期，第1140-1145页 |
| DOI：10.3969/j.issn.1003-0034.2016.12.015 |
| 基金项目:宁波市临床特色重点专科项目基金（编号：2013-88） |
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中文摘要:
目的：采用Meta分析法比较保肢治疗与截肢治疗治疗局限性EnnekingⅡ期骨肉瘤合并病理性骨折患者术后5年总体生存率、局部复发及转移发生率结果的临床研究。
方法：计算机检索自1970年1月1日至2015年12月1日，Cochrane图书馆（2015年12期）、PubMed、Ovid、Spinger Link、Embase、CNKI及万方等数据库有关保肢治疗与截肢治疗局限性EnnekingⅡ期骨肉瘤合并病理性骨折患者的文献，筛选出符合纳入标准的文献，并对其进行质量评价。采用Cochrane协作网提供的RevMan 5.0软件对纳入研究结果进行Meta分析，并对数据进行异质性检验。计算保肢与截肢治疗的局部复发、5年总体生存率及转移发生危险的优势比。
结果：符合纳入标准的文献10篇，总样本量453例，其中保肢治疗组315例，截肢治疗组138例。截肢组骨肉瘤5年总体生存率比保肢治疗组低[OR=2.88，95%CI（1.40，5.93）]，保肢组转移发生率更少[OR=0.43，95%CI（0.20，0.94）]，保肢组与截肢组的局部复发率没有明显差异[OR=1.47，95%CI （0.73，2.97）]。通过选择用MSTS系统评价时，保肢组在功能康复结果中优于截肢组。
结论：保肢治疗作为一种替代治疗局限性EnnekingⅡ期骨肉瘤合并病理性骨折患者的治疗方法，比截肢治疗并没有显着增加局部复发的风险和5年生存率，保肢治疗还有较低转移发生的风险。 |
| 【关键词】骨肉瘤 截肢术 Meta分析 |
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| Meta-analysis on limb salvage and amputation for patients with local EnnekingⅡosteosarcoma |
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ABSTRACT
Objective: To explore 5-year survival rate,local recurrence and metastasis rate of limb salvage and amputation for patients with local EnnekingⅡosteosarcoma by Meta-analysis.
Methods: From January 1,1970 to December 1,2015,Subject term and keywords about limb salvage and amputation for local EnnekingⅡosteosarcoma with pathological fracture were searched from Cochrane,PubMed,Ovid,Spinger Link,Embase,CNKI and WanFang database foundation. Literature confirm with inclusion criteria were choose and quality evaluation were performed. RevMan 5.0 software from Cochrane collaboration was used to perform Meta-analysis. Local recurrence,5-year survival rate and odds ratio of transfer risk were compared between limb salvage and amputation group.
Results: Ten literatures confirm with inclusion criteria were included,and total sample size was 453. There were 315 patients in limb salvage group and 138 patients in amputation group. Five-year survival rate in amputation group was lower than that of limb salvage group [OR=2.88,95%CI (1.40,5.93)],however metastasis rate in limb salvage was less than that of amputation group [OR=0.43,95%CI (0.20,0.94)];there were no significant differences in local recurrence between two groups [OR=1.47,95%CI (0.73,2.97)]. Functional rehabilitation in limb salvage group was better than that of amputation group by MSTS systematic review.
Conclusion: Limb salvage as an alternative in treating local EnnekingⅡ osteosarcoma with pathological fracture does not greatly increase risk of local recurrence or 5-year overall survival rate compared with amputation group,and has a lower risk of metastatic occurrence. |
| KEY WORDS Osteosarcoma Amputation Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 尹振春,刘丙根,庞清江.局限性EnnekingⅡ期骨肉瘤患者保肢与截肢治疗疗效的Meta分析[J].中国骨伤,2016,29(12):1140~1145 |
| 英文格式: | YIN Zhen-chen,LIU Bing-gen,PANG Qing-jiang.Meta-analysis on limb salvage and amputation for patients with local EnnekingⅡosteosarcoma[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(12):1140~1145 |
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