摘要
目的系统梳理并分析10年来股骨头坏死(osteonecrosis of the femoral head,ONFH)的中日友好医院(China-Japan Friendship Hospital,CJFH)分型相关生物力学及循证临床研究。方法计算机检索CNKI、WanFang Data、VIP、SinoMed、MEDLINE、ScienceDirect、PubMed、Web of Science数据库,搜集国内外与股骨头坏死CJFH分型相关的研究,检索时限为2012年6月至2022年5月。根据纳入及排除标准筛选文献,从生物力学研究、股骨头塌陷进展预测的有效性、股骨头坏死不同保髋选择的疗效评价、股骨头坏死的保髋选择4方面,对文献进行分析。结果共纳入34篇文献。其中,生物力学研究从宏观及微观角度分别对CJFH分型进行了探索和验证,多项研究将CJFH分型作为研究对象的分类基础。随着分型的升高,患者临床成功率及股骨头生存率均明显下降,且结论适用于大多数保髋治疗方式。CJFH分型对股骨头坏死进展塌陷率及治疗预后预测具有准确性和可重复性,为分型的临床应用提供了证据支持。结论CJFH分型可以应用于ONFH塌陷预测、疗效分析并指导治疗,其可在层面选择方面与新技术结合,在保证临床适用的同时提高准确率。
Objective To sort out and analyze the findings on biomechanics and evidence-based clinical study of the China-Japan Friendship Hospital(CJFH)classification of osteonecrosis of the femoral head(ONFH)in the past ten years.Methods Search for researches related to CJFH classification in CNKI,WanFang Data,VIP,SinoMed,MEDLINE,ScienceDirect,PebMed,Web of Science.Searching time was from July,2012 to June,2023.Literature was selected according to inclusion and exclusion criteria.The literature was analyzed from different perspectives,which could be categorized into four aspects:biomechanics,prediction of the collapse of the femoral head,assessment of different joint preserving protocols,and joint preserving choices.Results A total of 34 studies were included.Biomechanical studies explored and validated the CJFH classification from both macro and micro perspectives,providing ample theoretical support for the classification.Additionally,several studies used the CJFH classification to categorize their research subjects.As the classification level increased,both the clinical success rate and femoral head survival rate of patients significantly decreased,and this conclusion applied to most hip-preserving treatment methods.The CJFH classification accurately and reproducibly predicted the progression collapse rate and treatment prognosis of femoral head necrosis,providing evidence support for the clinical application of this classification.Conclusion CJFH classification can predict the collapse of the femoral head,assess joint preserving treatments,and guide clinical decisions.It can be combined with new technology in the aspect of layer selection to ensure clinical applicability and improve accuracy.
作者
刘天洋
孙伟
高福强
李子荣
LIU Tianyang;SUN Wei;GAO Fuqiang;LI Zirong(China-Japan Friendship School of Clinical Medicine,Capital Medical University,Beijing 100069,China;Department of Orthopedics,China-Japan Friendship Hospital,Beijing 100029,China;China-Japan Friendship School of Clinical Medicine,Peking University,Beijing 100029,China)
出处
《医学新知》
CAS
2024年第7期744-755,共12页
New Medicine
基金
中央高水平医院临床科研业务费专项(2024-NHLHCRF-PYI-01)
首都卫生发展科研专项项目自主创新项目(首发2024-2-40611)
中日友好医院“菁英计划”人才培育工程(ZRJY2021-GG12)
北京市自然科学基金面上项目(7242127)
中国中药协会骨伤科药物研究专业委员会骨伤科青年医师创新发展项目(GSKQNJJ-2023-007,2023-HX-141)
北京化工大学-中日友好医院生物医学转化工程研究中心联合项目(RZ2020-02)
中日友好医院横向课题/自发性研究项目(2024-HX-6,2022-HX-JC-7)。
关键词
股骨头坏死
CJFH分型
生物力学
循证临床实践
系统综述
Osteonecrosis of the femoral head
CJFH classification
Biomechanics
Evidence-based clinical study
Systematic review
