| 手法复位联合微创手术治疗骨质疏松性椎体压缩骨折疗效的Meta分析 |
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Received:April 02, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 胡月明 |
HU Yue-ming |
宁波市第二医院骨科中心, 浙江 宁波 315010 |
Orthopaedics Center, 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中心, 浙江 宁波 315010 |
Orthopaedics Center, Ningbo No.2 Hospital, Ningbo 315010, Zhejiang, China |
pqjey@sina.com |
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| 期刊信息：《中国骨伤》2015年28卷，第11期，第1042-1047页 |
| DOI：10.3969/j.issn.1003-0034.2015.11.014 |
| 基金项目:宁波市临床特色重点专科项目(编号:2013-88) |
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目的:应用Meta分析评价手法复位在联合经皮椎体成形术(percutaneous vertebroplasty,PVP)或经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)中的有效性,为临床治疗提供参考。
方法:检索中国学术期刊网、万方数据库、Web of Science 和PubMed,获得1987年1月至2014年4月期间有关手法复位和PVP及PKP治疗骨质疏松性椎体压缩骨折的临床对照研究文献,对入选的文献进行质量评价,选择疼痛(VAS评分)缓解、后凸角(Cobb角)改善、椎体前缘高度恢复等作为Meta分析的评价指标。
结果:共纳入文献7篇,包含5篇随机对照研究,2篇非随机对照研究。2篇研究为手法复位联合PVP与单纯PVP治疗OVCF的效果,5篇研究为手法复位联合PKP与单纯PKP治疗OVCF的效果。所有研究均来自中国,共纳入410例研究对象(465个病椎).与单纯PVP比较,手法复位联合PVP能更好地改善Cobb角(WMD=-7.35;95%CI:-12.15,-2.54)和椎体前缘高度(p<0.01),但两组在VAS评分改善方面差异无统计学意义(WMD=-0.01;95%CI:-0.45,0.42);与单纯PKP比较,手法复位联合PKP治疗在VAS评分改善、Cobb角改善、椎体前缘高度恢复方面差异均无统计学意义(p>0.05).
结论:与单纯PVP及PKP治疗OVCF相比,手法复位联合PVP能更好地改善Cobb角和椎体前缘高度,而手法复位联合PKP在疼痛缓解、Cobb角改善、椎体前缘高度恢复方面均无明显优势。研究纳入的文献数量较少,有必要进一步开展大样本、高质量的随机对照研究予以证实。 |
| [关键词]:骨质疏松 椎体压缩骨折 正骨手法 经皮椎体成形术 经皮椎体后凸成形术 |
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| Effectiveness of manipulative reduction combined with minimally invasive surgery in the treatment of osteoporotic vertebral compression fracture:a meta-analysis |
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Abstract:
Objective:To evaluate the clinical efficacy of manipulative reduction combined with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF) using meta-analysis method,in order to provide a reference for clinical treatment.
Methods:A systematic computer-based search (from January 1987 to April 2014) from CNKI,Wanfang database,Web of Science and PubMed were performed for the collection of controlled clinical researches on manipulative reduction combined with PVP or PKP in treating OVCF. The quality of selected researches was evaluated. Meta-analysis was adopted to evaluate visual analog scale,Cobb angle,anterior height ratio of the injured vertebra.
Results:A total of 7 researches of 410 patients were included in the present analysis,there were 5 RCTs and 2 non-RCTs and all come from China. Manipulative reduction combined with PVP could got better improvement in Cobb angle (WMD=-7.35;95%CI:-12.15,-2.54) and anterior height ratio of the injured vertebra(p<0.01) than simple PVP,but no significant difference was found in improvement of visual analog scale(WMD=-0.01;95%CI:-0.45,0.42). There were no significant differences in the improvement of visual analog scale,Cobb angle,anterior height ratio of the injured vertebra between manipulative reduction combined with PKP and simple PKP (p>0.05).
Conclusion:Compared with simple PVP,manipulative reduction combined with PVP may result in more clinical efficacy on the improvement of Cobb angle and anterior ratio of the injured vertebra. And compared with simple PKP,manipulative reduction combined with PKP has no obvious advantages on the improvement of visual analog scale,Cobb angle,anterior height ratio of the injured vertebra. However,the number and quality of the literatures,may resulted in the effect of mistrust,so more large sample and high-quality RCTs are needed in future. |
| KEYWORDS:Osteoporosis Vertebral compression fracture Bone setting manipulation Percutaneous vertebroplasty(PVP) Percutaneous kyphoplasty (PKP) |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡月明,庞清江.手法复位联合微创手术治疗骨质疏松性椎体压缩骨折疗效的Meta分析[J].中国骨伤,2015,28(11):1042~1047 |
| 英文格式: | HU Yue-ming,PANG Qing-jiang.Effectiveness of manipulative reduction combined with minimally invasive surgery in the treatment of osteoporotic vertebral compression fracture:a meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(11):1042~1047 |
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