关节镜手术与开放手术治疗腘窝囊肿临床疗效的meta分析

目的 运用meta分析的方法探讨关节镜手术与开放手术治疗腘窝囊肿的临床疗效。方法 计算机检索PubMed、EBSCO、The Cochrane Library数据库、中国知网、万方数据库,检索内容为关节镜手术和开放手术治疗膝关节腘窝囊肿的临床随机对照试验(randomized controlled trial,RCT)半随机对照试验 (qRCT),检索时限为2000年1月至2017年9月。按纳入、排除标准进行文献筛选和质量评估,然后采用Newcastle Ottawa Scale(NOS)文献质量评价量表对文献进行质量评估,应用Rev Man 5.3软件进行meta分析。结果 纳入8篇文献,499例患者,关节镜手术组259例,开放手术切除组240例。本次meta分析表明,两组之间在术后复发率、术后感染率、术后好转率及手术切口长度之间相比,关节镜手术组相对于开放手术组有一定优势;而在手术时间及术后Lysholm评分之间关节镜组和开放手术组相比无明显优势,差异无统计学意义。结论 关节镜手术治疗膝关节腘窝囊肿与开放手术治疗腘窝囊肿相比,具有手术创伤小、术后并发症少、复发率低、恢复快等优势,同时还具有可处理伴发的关节内病变等优势。

A meta-analysis of the clinical efficacy of arthroscopic surgery and open surgery for the treatment of popliteal cyst

Objective To investigate the clinical efficacy of arthroscopic surgery and open surgery in the treatment of popliteal cyst by meta-analysis.Methods PubMed, EBSCO, the Cochrane Library, CNKI and Wanfang databases were searched for randomized controlled trial (RCT) and semi randomized controlled trials (qRCT) of arthroscopic and open surgery for popliteal cyst of the knee joint from January 2000 to September 2017. According to the inclusion and exclusion criteria, literature screening and quality evaluation were conducted. Then, Newcastle Ottawa scale (NOS) document quality evaluation scale was used to evaluate the quality of the literature, and rev man 5.3 software was used for meta analysis.Results Eight articles were included, including 499 patients, 259 patients in arthroscopic surgery group and 240 patients in open surgery group. The meta-analysis showed that compared with the open surgery group, the arthroscopic group had a certain advantage over the open surgery group in the postoperative recurrence rate, postoperative infection rate, postoperative improvement rate and incision length between the two groups; however, there was no significant difference between the two groups in the operation time and the postoperative Lysholm score.Conclusion Compared with open surgery, arthroscopic surgery for popliteal cyst of the knee joint has the advantages of less surgical trauma, less postoperative complications, low recurrence rate and rapid recovery, and it also has the advantages of dealing with concomitant intra-articular lesions.