| 微创与开放椎弓根固定治疗单节段胸腰段骨折疗效的系统评价 |
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Received:April 02, 2015
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| 期刊信息：《中国骨伤》2016年29卷，第3期，第220-227页 |
| DOI：10.3969/j.issn.1003-0034.2016.03.006 |
| 基金项目:卫生部医药卫生科技发展研究中心(编号;W2014ZT153,W2014ZT154) |
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| 目的:系统评价微创椎弓根固定(percutaneous pedicle screw fixation,PPSF)与开放椎弓根固定(open pedicle screw fixation,OPSF)治疗单节段胸腰段骨折疗效与安全性。方法:通过计算机检索Pubmed、EMbase、CNKI数据库并结合手工检索,按照既定的纳入和排除标准搜索1990年至2014年有关两种术式治疗单节段胸腰段骨折疗效的临床试验,对纳入的研究进行质量评价。使用Review Manager 5.3软件对数据进行系统评价,观察指标包括手术时间、手术切口长度、术中出血、术后引流量、住院时间、术后下床时间、手术前后疼痛评分、术后伤椎Cobb角改善程度、术后伤椎前缘高度恢复比。结果:共纳入15篇文献,随机对照试验2篇,病例对照试验13篇,共789例患者。结果提示,与OPSF组相比,PPSF组患者手术时间短、手术切口短、术中出血少、术后引流量少、住院时间短、手术前后疼痛评分变化大(P<0.000 01),术后伤椎Cobb角改善程度小(P=0.000 6);但在术后伤椎前缘高度恢复比(P=0.36)及术后下床时间(P=0.38)比较上,两种手术方式未见统计学差异。结论:远期效果上两种手术方式未见显著性差异。PPSF带给患者的创伤更小,疗效更好,值得进一步临床研究与学习。 |
| [关键词]:胸腰椎骨折 外科手术,微创性 Meta分析 |
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| Comparison of the clinical safety and efficacies of percutaneous pedicle screw fixation and open pedicle screw fixation for thoracolumbar fracture:a meta-analysis |
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| Abstract:Objective:To evaluate the efficacy and safety of percutaneous pedicle screw fixation(PPSF) and open pedicle screw fixation(OPSF) in the treatment of single level of thoracolumbar fracture. Methods:Databases including Pubmed, Embasem, CNKI were searched to collect clinical trials of the clinical safety and efficiency of PPSF and OPSF for single level of thoracolumbar unstable fracture, relevant proceedings and references were also retrieved manually. Studies from 1990 to 2014 that met the inclusion and exclusion standards were researched. The data were extracted and the methods from the studies were also evaluated. Data analysis was conducted with the Review Manager 5.3 software. Observation targets included operation time, intraoperative bleeding, postoperative bleeding, hospitalization time, the bed time, postoperative vertebral Cobb angle, vertebral body height, pain score and the length of incision operation. Results:Fifteen papers were finally studied, including 2 randomized controlled trials (RCT) and 13 case-control studies, involving 789 patients. Compared with OPSF, the PPSF in treating thoracolumbar fracture had shorter operation time, smaller operation incision, less intraoperative and postoperation bleeding, shorter hospitalization days, fewer pain(P<0.000 01), the less improvement in the change of Cobb angle(P=0.000 6). There was no significant difference in the improvement of vertebral body height(P=0.36), the bed time from operation to exercise(P=0.38) between OPSF and PPSF. Conclusion:Compared with OPSF, PPSF is better, safer, and has fewer pain. But there is no evidence that the PPSF is better in the recovery of the spinal height, and they have the same effect in the long-term follow-up for thoracolumbar fractures. PPSF brings minimally invasive to patients with better effect. It is worth further study and clinical research. |
| KEYWORDS:Thoracolumbar fractures Surgical procedures,minimally invasive 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: | 刘磊,刘光旺,马超.微创与开放椎弓根固定治疗单节段胸腰段骨折疗效的系统评价[J].中国骨伤,2016,29(3):220~227 |
| 英文格式: | LIU Lei,LIU Guang-wang,MA Chao.Comparison of the clinical safety and efficacies of percutaneous pedicle screw fixation and open pedicle screw fixation for thoracolumbar fracture:a meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(3):220~227 |
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