| 魏建,石仕元.SuperPATH入路与常规后外侧入路在全髋关节置换术中临床疗效的Meta分析[J].浙江中西医结合杂志,2021,31(5): |
| SuperPATH入路与常规后外侧入路在全髋关节置换术中临床疗效的Meta分析 |
| The clinical effect of superpath and posterolateral approaches in total hip replacement: a meta-analysis |
| 投稿时间：2021-02-13 修订日期：2021-04-19 |
| DOI： |
| 中文关键词: 全髋关节置换 SuperPATH 常规后外侧入路 Meta分析 |
| 英文关键词:Total hip replacement SuperPATH traditional posterolateral approach meta-analysis |
| 基金项目:2020年度浙江省中医药科技计划科研基金项目（2020ZA084） |
|
| 摘要点击次数: 447 |
| 全文下载次数: 4 |
| 中文摘要: |
| 目的 为改善全髋关节置换术的疗效，我们评价了SuperPATH技术与常规入路的临床疗效差异。
方法 计算机检索包括中国知网，万方，CBM，Pubmed，Embase，以及Cochrane library在内的数据库（检索时间自建库起-2019/10），确定纳入文献后，由两名研究员运用改良版Jadad评分量表（针对随机对照研究）或MINORS评分方法（针对非随机对照研究）进行文献质量评价，有异议时交由第三名研究员评价；另两名研究员对纳入文献数据提取。运用Revman 5.3 软件进行Meta分析。
结果 ①文献纳入：共纳入16篇文献，包括869例患者，其中SuperPATH入路组406例，常规后外侧入路组463例。②Meta分析结果：与常规后外侧入路相比，SuperPATH入路手术时间长（WMD=10.39，95%CI=[2.42,18.37]，P=0.01），切口长度短（WMD=-5.46,95%CI=[-7.19,-3.73]，P＜0.00001），术后1周髋关节评分高（WMD=9.20,95%CI=[5.34,13.05]，P＜0.00001），术中出血量少（WMD=-125.95，95%CI=[-153.59,-98.31]，P＜0.00001），首次下地时间早(WMD=-13.81,95%CI=[-21.42,-6.20]，P=0.0004)，术后7天内视觉模拟评分更低（WMD=-1.64,95%CI=[-2.37,-0.92]，P＜0.00001），差异有显著性意义；而在术后视觉模拟评分（VAS）3个月（WMD=-0.21,95%CI=[-0.61,0.20]，P=0.32）、6个月 （WMD=-0.18,95%CI=[-0.76,0.40]，P=0.54）；术后3个月Harris评分（WMD=2.42，95%CI=[0.94,3.90]，P=0.001）、6个月Harris评分（WMD=2.15，95%CI=[-0.11,4.40]，P=0.06）、12个月Harris评分（WMD=0.97，95%CI=[-0.43,2.36]，P=0.17）中，差异无显著性意义。
结论 SuperPATH入路具有小创口的优点，对患者造成的影响小，利于患者恢复，但与常规入路相比，其长期疗效是否仍然具有优势还需进一步研究。 |
| 英文摘要: |
| Objective In order to improve the curative effect of total hip arthroplasty, we evaluated the clinical difference between SuperPATH technique and conventional approach.
Methods The databases (Retrieval time since the establishment of the database-2019/10) including CNKI, WanFang, CBM, Pubmed, Embase and the Cochrane library were searched by computer. After they were included in the literature, two researchers evaluated the quality of the literature by using the modified Jadad scale (for randomized controlled study) or the MINORS scoring method (for non-randomized control studies). If there was any objection, they were handed over to the third researcher; The other two researchers extracted data from the included literature. Using Rev man 5.3 software for meta-analysis.
Results ① Literature inclusion: a total of 16 literatures were included, including 869 patients,406 patients in the SuperPATH approach group and 463 patients in the traditional posterolateral approach group. ② Meta analyze results: the results showed that compared with the traditional postlateral approach, the SuperPATH approach had longer operative time (WMD=10.39， 95%CI=[2.42,18.37],P=0.01),shorter incision length (WMD=-5.46, 95%CI=[-7.19,-3.73],P＜0.00001),higher Harris hip score at post operatiely a week(WMD=9.20,95%CI=[5.34,13.05],P＜0.00001),less intraoperative blood loss (WMD=-125.95,95%CI=[-153.59,-98.31],P＜0.00001),and the first time to land was earlier (WMD=-13.81,95%CI=[-21.42,-6.20],P=0.0004), Lower visual simulation score within 7 days after operation (WMD=-1.64,95%CI=[-2.37,-0.92],P＜0.00001),the difference is significant, but in the postoperative visual analogue score (VAS) 3 months (WMD=-0.21,95%CI=[-0.61,0.20],P=0.32),6 months (WMD=2.15,95%CI=[-0.11,4.40],P=0.06),and postoperatiely 3 months Harris score（WMD=2.42，95%CI=[0.94,3.90],P=0.001）,6 months Harris score(WMD=0.22,95%CI=[-0.42,0.87],P=0.49),12-month Harris score (WMD=0.97,95%CI=[-0.43,2.36],P=0.17),there was no significant difference.
Conclusion The Superpath approach has the advantages of small wound, little impact on patients, and is conducive to recovery. However, compared with the conventional approach, whether its long-term efficacy still has advantages needs further study. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
