| 股骨颈骨折术后股骨头坏死率及相关危险因素的Meta分析 |
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Received:April 21, 2021
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王焕 |
WANG Huan |
同济大学医学院医学统计学教研室, 上海 200092 |
Department of Medical Statistics,Tongji University School of Medicine,Shanghai 200092,China |
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| 韩春霞 |
HAN Chun-xia |
同济大学医学院医学统计学教研室, 上海 200092 |
Department of Medical Statistics,Tongji University School of Medicine,Shanghai 200092,China |
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| 艾自胜 |
and AI Zi-sheng |
同济大学医学院医学统计学教研室, 上海 200092 |
Department of Medical Statistics,Tongji University School of Medicine,Shanghai 200092,China |
azs1966@126.com |
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| 期刊信息：《中国骨伤》2022年35卷，第4期，第390-399页 |
| DOI：10.12200/j.issn.1003-0034.2022.04.018 |
| 基金项目:国家自然科学基金(编号:81872718);上海市卫生和计划生育委员会课题(编号:201840041);上海市教委本科重点建设项目(编号:201965) |
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目的: 研究2000年以后的成人股骨颈骨折患者内固定术后股骨头坏死发生率及相关危险因素以识别股骨头坏死高危人群。
方法: 检索PubMed、Medline、The Cochrane Library、中国知网、万方和维普数据库,收集2000年1月1日至2020年7月1日期间有关股骨颈骨折术后股骨头坏死及其危险因素的全部研究,根据入选和排除标准剔除不符合要求的研究。使用Endnote X9和Excel 2019进行文献提取、管理以及数据录入,利用R Studio 3.6.5软件进行Meta分析。通过亚组分析、敏感性分析和发表偏倚检测来研究异质性来源及评估结果的可靠性。
结果: 共纳入16篇文献,包括5 521例股骨颈骨折患者。Meta分析结果显示成人股骨颈骨折内固定术后股骨头坏死发生率为14.5%[95%CI(0.126-0.165)]。骨折移位情况[OR=0.27,95%CI(0.21-0.35)]和复位质量[OR=0.15,95%CI(0.09-0.27)]是股骨头坏死相关危险因素。亚组率分析结果显示:非移位型骨折坏死率为6.2%[95%CI(0.051-0.077)],移位型骨折坏死率为20.4%[95%CI(0.166-0.249)];骨折复位良好坏死率为8.3%[95%CI(0.072-0.095)],骨折复位不良坏死率为35.5%[95%CI(0.233-0.500)]。纳入的文献一致性较好,不存在发表偏倚。
结论: 2000年以后的成人股骨颈骨折内固定术后股骨头总坏死率有所下降,而移位型骨折和复位质量不良的患者坏死率仍处于较高水平。由于各原始文献对受伤至手术时间间隔的划分不一致,没有对该指标进行分析。 |
| [关键词]:股骨颈骨折 骨折固定术，内 股骨头坏死 危险因素 |
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| Femoral head necrosis rate and risk factors after internal fixation of femoral neck fracture:a Meta-analysis |
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Abstract:
Objective: To study the incidence and risk factors of osteonecrosis of the femoral head (ONFH) after internal fixation in adult patients with femoral neck fracture (FNF) after 2000,and identify high-risk population of ONFH.
Methods: PubMed,Medline,The Cochrane Library,CNKI,Wanfang and VIP Database were searched to collect all the literatures on ONFH and related risk factors after internal fixation of FNF from January 1th 2000 to July 1th 2020. Study extraction was performed according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literatures extraction,management and data entry,and R Studio 3.6.5 software was used for Meta-analysis. Subgroup analysis,sensitivity analysis and publication bias detection were used to explore the sources of heterogeneity and the reliability of the evaluation results.
Results: A total of 16 studies with 5521 patients were included. Meta-analysis showed that the incidence of ONFH after internal fixation for adult FNF was 14.5%[95% CI(0.126-0.165)]. Fracture displacement[OR=0.27,95%CI(0.21-0.35)] and reduction quality[OR=0.15,95%CI(0.09-0.27)] were related risk factors for ONFH. The results of subgroup rate analysis showed that the non-displaced fracture necrosis rate was 6.2%[95%CI(0.051-0.077)] and the displaced fracture necrosis rate was 20.4%[95%CI(0.166-0.249)];the good reduction fracture necrosis rate was 8.3%[95%CI(0.072-0.095)] and the poor reduction fracture necrosis rate was 35.5%[95%CI(0.233-0.500)]. The included literatures have good consistency and no publication bias.
Conclusion: After 2000,the total incidence of ONFH after internal fixation of adult FNF has decreased,while the necrosis rates of patients with displaced fracture and poor reduction are still at a high level. The interval between injury and surgery was not analyzed in this study because of the inconstant division in the original literature. |
| KEYWORDS:Femoral neck fracture Fracture fixation,internal Femoral head necrosis Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王焕,韩春霞,艾自胜.股骨颈骨折术后股骨头坏死率及相关危险因素的Meta分析[J].中国骨伤,2022,35(4):390~399 |
| 英文格式: | WANG Huan,HAN Chun-xia,and AI Zi-sheng.Femoral head necrosis rate and risk factors after internal fixation of femoral neck fracture:a Meta-analysis[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(4):390~399 |
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