本文選題：骨質(zhì)疏松　切入點：粗隆間骨折　出處：《新疆醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:不穩(wěn)定型骨質(zhì)疏松性股骨粗隆間骨折患者通常需要外科手術(shù)治療,本文旨在利用Meta分析的方法綜合評價防旋型股骨近端髓內(nèi)釘(proximal femoral nail antirotation,PFNA)與關(guān)節(jié)置換(himiarthroplasty,HA)治療不穩(wěn)定型骨質(zhì)疏松性股骨粗隆間骨折的療效評價。方法:通過計算機檢索萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫、中國知網(wǎng)、Pubmed、Embase等數(shù)據(jù)庫的相關(guān)文獻資料,檢索文獻時間截止2017年01月,語言不限。檢索關(guān)鍵詞為:股骨粗隆間骨折或股骨轉(zhuǎn)子間骨折(Intertrochanteri c fracture),骨質(zhì)疏松(osteoporosis),防旋型股骨近端髓內(nèi)釘(PFNA),關(guān)節(jié)置換(himiarthroplasty)。利用Rev Man5.35對納入的文獻數(shù)據(jù)進行Meta分析。結(jié)果:共納入9項隨機對照試驗,共969例不穩(wěn)定型骨質(zhì)疏松性股骨粗隆間骨折患者,其中P FNA組493例,HA組476例。Meta分析結(jié)果顯示:與HA組相比,PFNA組手術(shù)時間更短[SMD=-1.03,95%CI(-1.91,-0.15),P=0.02],術(shù)中失血量更少[SMD=-3.81,95%CI(-6.79,-1.83),P0.05],術(shù)后病死率更低[RR=0.57,95%CI(0.40,0.82),P=0.003],其差異均有統(tǒng)計學(xué)意義;住院時間、術(shù)后并發(fā)癥、術(shù)后髖關(guān)節(jié)功能評分和優(yōu)良率差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:PFNA在治療不穩(wěn)定型骨質(zhì)疏松性股骨粗隆間骨折的手術(shù)時間、術(shù)中失血量和病死率等方面均優(yōu)于HA;兩種手術(shù)方式在住院時間、術(shù)后并發(fā)癥、術(shù)后患髖Harris功能評分和髖關(guān)節(jié)功能優(yōu)良率等方面無顯著差異;PFNA具有手術(shù)時間短、手術(shù)創(chuàng)傷小、術(shù)中失血量少和術(shù)后患者病死率低等優(yōu)點,其對于不穩(wěn)定型骨質(zhì)疏松性股骨粗隆間骨折患者的治療是一種合理的選擇。
[Abstract]:Objective: unstable osteoporotic intertrochanteric fractures usually require surgical treatment. The purpose of this paper is to evaluate the efficacy of proximal femoral nail antirotation Meta analysis in the treatment of unstable osteoporotic femoral intertrochanteric fractures. WIP database, Chinese knowledge network Pubmedum Embase and other databases related to the literature retrieval time as of January 2017, The key words are intertrochanteri c fracture, osteoporosis, intramedullary intramedullary nail (PFNAN), joint replacement (Rev Man5.35) and Meta analysis. Fruit: included in 9 randomized controlled trials, A total of 969 patients with unstable osteoporotic intertrochanteric fracture of femur, The results of meta-analysis in 493 cases of PFNA group showed that compared with HA group, the operation time of PFNA group was shorter [SMD-1.03 + 95CIN -1.91U -0.15P0. 02], the amount of blood lost during operation was lower [SMD-3.8195CI-6.795 CI-1.83CU], and the postoperative mortality was lower [RR0.5795CIT 0.400.82P0.003], the difference was significant. There was no significant difference in hip function score and excellent and good rate after operation (P 0.05). Conclusion the operative time of the treatment of unstable osteoporotic intertrochanteric fracture of femur with 1% PFNA is not significant (P 0.05). There were no significant differences in hospital stay, postoperative complications, postoperative hip Harris score and excellent and good rate of hip joint function between the two operative methods. It is a reasonable choice for the treatment of unstable osteoporotic intertrochanteric fracture of femur because of the advantages of less blood loss during operation and lower fatality rate after operation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3;R580

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