摘要
目的通过循证医学,研究诱导膜与Ilizarov骨搬运技术治疗下肢感染性骨缺损文献,比较二者临床疗效,为临床决策提供参考。方法计算机检索中英文数据库收录的诱导膜技术和Ilizarov骨搬运技术治疗下肢长骨感染性骨缺损文献,利用RevMan 5.3软件Meta分析术中出血量、手术次数、愈合时间、并发症、临床疗效、末次随访患肢膝关节Iowa及踝关节Iowa评分。结果共纳入9篇文献,435例患者。Meta分析结果:两组手术次数[(MD=-0.61,95%CI(-0.89,-0.33),P<0.0001)]、愈合时间[(MD=-6.66,95%CI(-11.35,-1.97),P=0.005)]、并发症发生率[(OR=0.22,95%CI(0.14,0.34),P<0.00001)],差异有统计学意义:术中出血[(MD=51.60,95%CI(-57.34,160.55),P=0.35)]、临床疗效{骨性结局[(OR=1.18,95%CI(0.51,2.69),P=0.70)]、功能结局[(OR=1.78,95%CI(0.89,3.55),P=0.10)]},患膝[(MD=0.09,95%CI(-2.95,3.12),P=0.95)]及踝[(MD=1.14,95%CI(-1.37,3.64),P=0.37)]关节评分,差异无统计学意义。结论诱导膜技术和Ilizarov骨搬运技术治疗感染性骨缺损,均取得较好疗效;诱导膜技术手术次数、愈合时间、并发症等较Ilizarov骨搬运技术更有优势。
Objective By means of evidence-based medicine,the literatures on the treatment of infectious bone defects in lower extremities by induced membrane and Ilizarov bone transport technique were analyzed,and the clinical effect of the two techniques was compared,aiming to provide references for clinical decision-making.Methods The literatures on the treatment of infectious bone defects in lower extremities by induced membrane technique and Ilizarov bone transport technique were searched by computer in both Chinese and English databases,and the blood loss,operation times,healing time,complications,clinical effect,and Iowa scores of the knee joint and ankle joint of the affected limb were meta-analyzed by RevMan 5.3 software.Results A total of 9 articles and 435 patients were included.Results of metaanalysis:There were statistically significant differences in the operation times [(MD=-0.61,95%CI(-0.89,-0.33),P<0.000 1)],healing time [(MD=-6.66,95%CI(-11.35,-1.97),P=0.005)],and incidence of complications[(OR=0.22,95%CI(0.14,0.34),P<0.000 01)] between the two groups.As to blood loss [(MD=51.60,95%CI(-57.34,160.55),P=0.35)],clinical effect {boneoutcome [(OR=1.18,95%CI(0.51,2.69),P=0.70)],functional outcome [(OR=1.78,95%CI(0.89,3.55),P=0.10)],scores of knee joint [(MD=0.09,95%CI(-2.95,3.12).P=0.95)] and ankle joint [(MD=1.14,95%CI(-1.37,3.64),P=0.37)],the difference was not statistically significant.Conclusion Induction membrane technique and Ilizarov bone transport technique for the treatment of infectious bone defects have achieved equivalent satisfactory results.Induced membrane technique has more advantages in operation times,healing time and complications,compared to Ilizarov bone transport technique.
作者
亢哲
邓宇
屈文强
付攀峰
商炜
祝少博
Kang Zhe;Deng Yu;Qu Wenqiang;Fu Panfeng;Shang Wei;Zhu Shaobo(Orthopedics Center,Zhongnan Hospital of Wuhan University,Wuhan Hubei,430071,China)
出处
《生物骨科材料与临床研究》
CAS
2020年第5期25-31,共7页
Orthopaedic Biomechanics Materials and Clinical Study
