摘要
目的评价全髋关节置换术应用小切口是否优于传统长切口。方法收集所有关于微创小切口与传统切口在全髋关节置换术中应用比较的随机对照试验(RCT),按Cochrane协作网标准逐个进行质量评价和Meta分析。结果共纳入3篇RCT,包括339例患者。3个研究显示微创小切口组在术中失血量、总失血量、手术用时方面少于传统长切口,术中、术后并发症发生率无统计学意义,而对于术后镇痛药物用量、患肢功能恢复、术后影像学评价及远期手术效果由于各试验采用了不同的评价指标,不能进行合并分析。结论微创小切口和传统长切口都可以用于全髋关节置换术,采用微创小切口在术中失血量、总失血量、手术用时方面少于传统长切口,在术中及术后并发症方面,两种切口的差异无统计学意义。因本研究的样本量较小,纳入的研究数量少,缺乏足够的证据,尚需更多设计严格的研究以增加证据的强度。
Objective To evaluate whether the minimally invasive incision is better than conventional incision for total hip arthroplasty （THA）. Methods All randomized controlled trials （RCTs） about comparation between minimally invasive and conventional ineision for total hip arthroplasty were identified and the quality of each were evaluated by using the standard provided by Coehrane Collaboration. Some results were Meta-analysised. Results Three RCTs were included. The combined results of meta-analysis showed that compared with conventional incision, minimally invasive incision for total hip arthroplasty could reduee the duration of operation, the amount of intraoperative blood loss, and the amount of total blood loss, but the rate of complications had no differenee. Conclusion Compared with conventional incision, minimally invasive incision for total hip arthroplasty ean reduce the duration of operation, the amount of intraoperative blood loss and the amount of total blood loss , but the rate of complications has no differenee. However , the trials available for this systematic review are too few and small for reliable estimates of the relative effects of minimally invasive and conventional incision for total hip arthroplasty.Further studies are needed to determine these effects.
出处
《中国骨与关节损伤杂志》
2009年第7期604-607,共4页
Chinese Journal of Bone and Joint Injury
关键词
全髋关节置换术
微创
传统切口
随机对照试验
系统评价
Total hip arthroplasty
Minimally invasive
ConventionM incision
Systematic review
Randomized controlled trim
