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肥胖影响肩袖修复术后结果的Meta分析
Hits: 1800   Download times: 301   Received:March 06, 2023    
作者Author单位UnitE-Mail
梁钧文 LIANG Jun-wen 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
杨智涛 YANG Zhi-tao 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
刘涛 LIU Tao 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
王锡豪 WANG Xi-hao 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
方森 FANG Sen 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
张柏荣 ZHANG Bai-rong 兰州大学第二医院骨科, 甘肃 兰州 730030 Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China  
韵向东 YUN Xiang-dong 兰州大学第二医院骨科, 甘肃 兰州 730030
甘肃省骨关节疾病研究重点实验室, 甘肃 兰州 730030
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
Key Laboratory of Bone and Joint Disease of Gansu Province, Lanzhou 730030, Gansu, China
xiangdongyun@126.com 
期刊信息:《中国骨伤》2023年36卷,第12期,第1196-1202页
DOI:10.12200/j.issn.1003-0034.2023.12.017
基金项目:甘肃省科技厅自然科学基金项目(编号:22JR11RA051); 兰州大学第二医院"萃英科技创新"计划临床拔尖技术项目(编号:CY2019-BJ04)


目的:系统评价肥胖对于肩袖修复术后结果的影响。

方法:检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库(China biology medicine,CBM)、知网、万方、维普数据库,收集建库至2022年8月1日比较肥胖与肩袖修复术后结果关系的全部文献,由2位作者各自独立根据纳排除标准对入选文献进行筛选。采用Endnote X9 和 Excel 2019 进行文献提取、管理以及数据录入,并采用渥太华纽卡斯尔量表(Newcastle-Ottawa Scale,NOS)对纳入文献进行质量评价。采用STATA 16.0及RevMan 5.4软件对肥胖与非肥胖组术后再撕裂率、再手术率、并发症发生率,美国肩肘外科协会评分(American Shoulder and Elbow Surgeons,ASES),肩关节疼痛视觉模拟评分(visual analogue scale,VAS),手术时间,肩关节外旋角度进行Meta分析。

结果:共纳入13篇文献,包括6篇回顾性研究,5篇病例对照研究,1篇前瞻性队列研究,1篇未能获取全文的研究摘要,共计85 503例患者(肥胖组31 973例,非肥胖组53 530例)。Meta分析结果显示,两组再撕裂率[OR=2.58,95% CI(1.23,5.41),P=0.01]、再手术率[OR=1.31,95% CI(1.21,1.42),P<0.00]、并发症发生率[OR=1.57,95% CI(1.31,1.87),P=0.00]、ASES评分[MD=-3.59,95% CI(-5.45,-1.74),P=0.00]、VAS[MD=0.24,95% CI(0.00,0.49),P=0.05]比较差异有统计学意义,而手术时间[MD=6.03,95% CI(-7.63,19.69),P=0.39]、肩关节外旋角度[MD=-1.79,95% CI(-5.30,1.71),P=0.32]比较差异无统计学意义。

结论:肥胖会导致肩袖修复术后更高的再撕裂率、再手术率、并发症发生率,更差的肩部功能和疼痛状况。
[关键词]:肥胖  肩袖修复术  预后  Meta 分析
 
Meta-analysis of obesity on the outcome of rotator cuff repair
Abstract:

Objective To systematically evaluate obesity on the outcome of rotator cuff repair.

Methods Literatures on the relationship between obesity and outcomes after rotator cuff repair were searched from PubMed,Embase,Cochrane Library,Web of Science,China biology medicine(CBM),CNKI,Wanfang and VIP databases from building database to August 1,2022,and were screened independently by two authors according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literature extraction,management and data entry,and Newcastle-Ottawa Scale (NOS) was used to evaluate quality of the included literatures. STATA 16.0 and RevMan 5.4 softwares were used to evaluate postoperative retear rate,reoperation rate,complication rate,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),operative time and external rotation angle of shoulder joint pain were analyzed.

Results Totally 13 literatures were included,including 6 retrospective studies,5 case-control studies,1 prospective cohort study,and 1 abstract of a study for which the full text was not available,with 85 503 patients (31 973 in obese group and 53 530 in non-obese group). Meta-analysis showed there were statistical differences between two groups in retear rate[OR=2.58,95% CI(1.23,5.41),P=0.01],reoperation rate[OR=1.31,% CI(1.21,1.42),P<0.00],complication rate[OR=1.57,% CI(1.31,1.87),P=0.00],ASES score[MD=-3.59,% CI(-5.45,-1.74),P=0.00],and VAS[MD=0.24,% CI(0.00,0.49),P=0.05]. While there were no differences between two groups in operative time[MD=6.03,% CI(-7.63,19.69),P=0.39],external rotation angle of shoulder joint[MD=-1.79,% CI(-5.30,1.71),P=0.32].

Conclusion Obesity is associated with higher rates of retear,resurgery,complications,poorer shoulder function and pain after rotator cuff repair.
KEYWORDS:Obesity  Rotator cuff repair  Prognosis  Meta-analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:梁钧文,杨智涛,刘涛,王锡豪,方森,张柏荣,韵向东.肥胖影响肩袖修复术后结果的Meta分析[J].中国骨伤,2023,36(12):1196~1202
英文格式:LIANG Jun-wen,YANG Zhi-tao,LIU Tao,WANG Xi-hao,FANG Sen,ZHANG Bai-rong,YUN Xiang-dong.Meta-analysis of obesity on the outcome of rotator cuff repair[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(12):1196~1202
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