| 直接外侧入路与传统后侧入路行全髋关节置换术疗效差异的Meta分析 |
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| 引用本文： | 车先达,韩鹏飞,顾晓东,高阳阳,陈韬予,李鹏翠,卫小春. 直接外侧入路与传统后侧入路行全髋关节置换术疗效差异的Meta分析[J]. 中华全科医学, 2019, 17(9): 1586-1591. DOI: 10.16766/j.cnki.issn.1674-4152.001004 |
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| 作者姓名： | 车先达 韩鹏飞 顾晓东 高阳阳 陈韬予 李鹏翠 卫小春 |
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| 作者单位： | 1. 山西医科大学第二临床医学院, 山西 太原 030001; |
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| 基金项目： | 国家国际科技合作专项(2015DFA33050);国家自然科学基金青年基金项目(81601949);山西省回国留学人员科研资助项目(2016-118) |
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| 摘 要： | 目的 通过Meta分析比较直接外侧入路与传统后侧入路行全髋关节置换术的临床疗效差异。 方法 检索包括国内外于2008年8月—2018年8月已发表的临床对照研究。所检索的数据库包括Embase、Pubmed、PQDT、Cochrane Library、中国知网、维普、万方、CBM等。提取数据后,采用Review Manager 5.3软件进行数据分析。 结果 依据以上检索策略,共检索到相关文献441篇,并最终纳入12篇文献。通过比较发现,在行全髋关节置换术时,直接外侧入路术后髋关节后伸活动度低于传统后侧入路[95% CI(-10.93~-7.01),P<0.001],两者差异有统计学意义。而且直接外侧入路术后髋关节前屈活动度[95% CI(8.87~12.70),P<0.001]及术后Trendelenburg试验阳性率[95% CI(1.53~13.68),P=0.007]均高于传统后侧入路组,差异有统计学意义。其余结局指标如术后Harris髋关节评分[95% CI(-0.14~0.62),P=0.21]、术后并发症[95% CI(0.29~1.07),P=0.08]、手术所需时间[95% CI(-7.31~5.94),P=0.84],2组间差异均无统计学意义。 结论 直接外侧入路与传统后侧入路行全髋关节置换术均能取得良好的治疗效果,且Harris髋关节评分及并发症相当。虽然直接外侧入路组在术后Trendelenburg试验阳性率高于传统后侧入路组,但是直接外侧入路仍不失为是一种安全可行的治疗选择。
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| 关 键 词： | 直接外侧入路 后外侧入路 全髋关节置换术 Meta分析 |
| 收稿时间： | 2018-09-02 |
The clinical efficacy of direct lateral approach versus traditional posterior approach for the treatment of total hip arthroplasty: a meta-analysis |
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| Affiliation: | Department of Orthopaedic Surgery, the Second Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030001, China |
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| Abstract: | Objective To compare the clinical efficacy between direct lateral approach and traditional posterior approach in the treatment of total hip arthroplasty by Meta-analysis. Methods The study included clinical trials published both at home and abroad from August 2008 to August 2018. The retrieval was performed in the online databases include Embase, Pubmed, PQDT, China National Knowledge Infrastructure (CNKI), CQVIP, Wanfang Data, CBM, etc. Statistical software Review Manager 5.3 was used for data-analysis. Results Based on the above search strategy to search papers, a total of 441 relevant literatures were retrieved, and eventually 12 literatures were included. The outcome measurements include 5 aspects such as harris hip score, range of motion, complications, time of surgery, trendelenburg test. Results The analysis showed that the direct lateral approach was inferior to Traditional Posterior Approach in Hip extension activity[95% CI (-10.93- -7.01), P<0.001], and the Direct Lateral Approach was superior to Traditional Posterior Approach in Hip flexion activity[95% CI (8.87-12.70), P<0.001], Trendelenburg test[95% CI (1.53-13.68), P=0.007]. But in Harris hip score [95% CI (-0.14-0.62), P=0.21]; Complications [95% CI (0.29-1.07), P=0.08]; Time of surgery [95% CI (-7.31-5.94), P=0.84], there was no significant differences between the two procedures. Conclusions Both the direct lateral and traditional posterior approach in total hip arthroplasty can achieve good effect, and the complications and harris hip score are comparable. Although the direct lateral approach group is superior to the traditional posterior approach group in trendelenburg test, the direct lateral approach is still a safe and feasible treatment option. |
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