| 股骨颈骨折患者早期手术对比后期手术安全性的Meta分析 |
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Received:January 27, 2011
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| 期刊信息：《中国骨伤》2011年24卷，第6期，第500-503页 |
| DOI：10.3969/j.issn.1003-0034.2011.06.018 |
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目的：关于股骨颈骨折早期手术是否可以降低患者病死率的研究结果并不完全一致，本研究探讨股骨颈骨折患者早期对比后期行手术治疗对患者病死率的影响。
方法：通过计算机检索Medline、EMBASE、CENTRAL(the Cochrane central register of controlledtrials)、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)等，收集股骨颈骨折患者早期手术对比后期手术治疗效果的研究文献。应用统计软件Stata 11.0进行数据分析，计算其合并相对危险度(relative risk,RR)和95%置信区间(confidence interval,CI).采用Egger法对发表偏倚进行量化检测。
结果：纳入分析的文章有6篇，均为观察性的队列研究，共纳入8 430例患者。合并分析结果表明：早期行手术治疗患者的死亡风险是后期行手术治疗的64%(RR=0.64,95%CI:0.55～0.73,P=0.000);按死亡时间为30 d以内的早期术后死亡和6个月及以上的后期死亡分为2个亚组。早期病死率，早期手术与后期手术无差别(RR=0.93,95%CI:0.69～1.18,P=0.076);后期病死率，早期行手术治疗患者的病死率是后期手术治疗的59%(RR=0.59,95%CI:0.49～0.69,P=0.000).
结论：股骨颈骨折患者早期行手术治疗可以显着降低患者的病死率。 |
| [关键词]:股骨颈骨折 外科手术 Meta分析 病死率 |
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| Meta-analysis of studies on mortality of early surgery vs delayed surgery for patients with femoral neck fractures |
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Abstract:
Objective: Current guidelines indicate that surgery for femoral neck fracture should be performed within 24 hours. But the effect of early surgery on mortality was not consistent with each other. This study is to explore the effect of early surgery on the risk of death among elderly patients with femoral neck fracture.
Methods: By searching Medline,PubMed,CENTRAL(the Cochrane central register of controlledtrials),CBM,CNKI and VIP et al,published documents about studies of early surgery VS delayed surgery on mortality for femoral neck fractures were collected. The data were analysised by using statistic software Stata 11.0. Random or fixed effect models were applied to conduct Meta analysis on the study results,the combined relative risk (RR) and the 95% confidence interval(CI) were calculated as well.
Results: Six cohort studies and 8 430 patients were included in the combined analysis,which indicated that 64% death risk was observed in the early surgery group compared to the delayed surgery group(RR=0.64,95%CI:0.55～0.73,P=0.000). The death was divided into two subgroups:one was early death with 30 days and the other was late death after 6 months. For the early death,there was no statistic significance between early surgery and delayed surgery(RR=0.93,95%CI:0.69～1.18,P=0.076). And for the late death,only 59% death risk was observed in the early surgery group(RR=0.59,95%CI:0.49～0.69,P=0.000)compared to the delayed surgery group.
Conclusion: Early surgery was associated with a lower risk of death for femoral neck fracture patients. |
| KEYWORDS:Femoral neck fractures Surgical procedures,operative Meta analysis Mortality |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐俊涛,王小军.股骨颈骨折患者早期手术对比后期手术安全性的Meta分析[J].中国骨伤,2011,24(6):500~503 |
| 英文格式: | XU Jun-tao,WANG Xiao-jun.Meta-analysis of studies on mortality of early surgery vs delayed surgery for patients with femoral neck fractures[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(6):500~503 |
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