脱钙骨基质在四肢植骨中应用的有效性及安全性的系统评价与Meta分析

目的研究脱钙骨基质（DBM）在四肢植骨手术中的疗效，对所有已获得的数据进行系统综述和Meta分析，评价DBM在四肢植骨手术中作为骨移植替代物的有效性及安全性。 方法在PubMed、MEDLINE，EMBASE和Cochrane协作网图书馆中进行文献检索。检索DBM在四肢植骨手术中的应用，根据文献纳入标准进行选择。重点选择数据可以被提取以及能够进行Meta分析的文章。 结果44项研究符合纳入标准，其中随机对照试验3篇，病例系列研究27篇，病例-对照研究14篇。所有的研究报告均未报道DBM作为移植物，融合部位出现破坏或者移位。 结论1项病例系列研究认为，使用Allomatrix DBM作为自体骨移植的替代品，其极高的并发症风险是不可接受的。余下43项研究报告得出的结果均为DBM与自体骨和其他骨移植替代材料相比较具有非劣效性，根据患者的随访报告结果可以认为DBM作为骨移植替代材料的融合率和安全性是有保障的，但是这方面证据的数量和质量是非常有限的。

The effectiveness and safety of demineralized bone matrix in limbs bone grafting: a systemicreview and meta-analysis

ObjectiveTo study the efficacy of decalcified bone matrix (DBM) in limb bone grafting surgery. A systematic review and meta-analysis of all available data was conducted to evaluate the effectiveness and safety of DBM as a bone graft substitute in limb limb grafting. MethodsLiterature research was performed in the PubMed, MEDLINE, EMBASE and the Cochrane Library. The application of DBM in bone grafting of limbs was retrieved and selected according to the literature inclusion criteria. Focus on selecting articles that can be extracted and meta-analyzed. ResultsForty-four studies met the inclusion criteria, including three randomized controlled trials, 27 case series studies, and 14 case-control studies. None of the studies reported the destruction or displacement of DBM as a fusion site of the graft. ConclusionsA series of case studies suggest that the use of Allomatrix DBM as a surrogate for autologous bone grafts has an unacceptably high risk of complications. The results of the remaining 43 studies reported that DBM was non-inferior compared to autologous bone and other bone graft substitute materials. According to the follow-up report of patients, the fusion rate and safety of DBM as a substitute material for bone graft can be considered. It is guaranteed, but the amount and quality of evidence in this area is very limited.