發(fā)布時間：2018-12-10 16:15

【摘要】：目的:對表面髖關(guān)節(jié)置換(HRA)與全髖關(guān)節(jié)置換(THA)治療骨關(guān)節(jié)炎的療效進(jìn)行系統(tǒng)評價。比較兩種術(shù)式的差異,以更好的指導(dǎo)臨床工作。方法:計算機檢索MEDLINE、EMBASE、Cochrane協(xié)作網(wǎng)數(shù)據(jù)庫,檢索時間為數(shù)據(jù)庫建立到2016年6月。國內(nèi)骨科雜志和有關(guān)會議資料采用人工方法檢索。挑選有關(guān)的隨機對照試驗文獻(xiàn),用Cochrane協(xié)作網(wǎng)提供的Review Manager 5.3軟件進(jìn)行文獻(xiàn)質(zhì)量評價和數(shù)據(jù)統(tǒng)計分析。結(jié)果:共納入8文獻(xiàn),總共720例病人中有355人接受表面髖關(guān)節(jié)置換術(shù),另外365人接受全髖關(guān)節(jié)置換術(shù)。Meta分析結(jié)果:HRA組與THA組病人在術(shù)后1年WOMAC疼痛評分差異有統(tǒng)計學(xué)意義[MD=-1.98,95%CI(-3.74,-0.22),P=0.03],HRA組低于THA組;術(shù)后6個月、2年、5年的評分無明顯差異(P0.05)。THA組術(shù)后6個月的SF-36生活質(zhì)量評分較HRA組高,其余隨訪時間段內(nèi)無明顯差異。兩組在術(shù)后Harris功能評分、翻修率和術(shù)后并發(fā)癥發(fā)生率差異無統(tǒng)計學(xué)意義(P0.05);與HRA組對比,THA組手術(shù)時間更短(P0.0001)、出血更少(P=0.02)。結(jié)論:HRA在術(shù)后1年的疼痛評分方面稍占優(yōu)勢,THA術(shù)后6個月的生活質(zhì)量評分優(yōu)于HRA,但在其他隨訪時間段內(nèi)兩組無明顯差異。兩組術(shù)后的功能評分、翻修率和并發(fā)癥發(fā)生率差異無統(tǒng)計學(xué)意義。HRA手術(shù)時間和手術(shù)出血較THA多。
[Abstract]:Objective: to evaluate the efficacy of surface hip replacement (HRA) and total hip replacement (THA) in the treatment of osteoarthritis. To compare the differences between the two surgical methods and to guide the clinical work better. Methods: the database of MEDLINE,EMBASE,Cochrane collaboration network was searched by computer, and the retrieval time was established until June 2016. Domestic orthopedic journals and related conference materials were retrieved manually. The literature of the randomized controlled trial was selected and the literature quality evaluation and data statistical analysis were carried out with the Review Manager 5.3 software provided by the Cochrane Cooperative Network. Results: a total of 8 literatures were included. 355 of 720 patients underwent superficial hip replacement. The results of Meta analysis showed that there was a significant difference in WOMAC pain score between HRA group and THA group one year after operation [MD=-1.98,95%CI (-3.74 鹵0.22), P < 0.03], HRA group was lower than THA group. There was no significant difference in the scores of 6 months, 2 years and 5 years after operation (P0.05) the SF-36 quality of life in the). THA group was higher than that in the HRA group, and there was no significant difference in the other follow-up periods. There was no significant difference in Harris functional score, revision rate and postoperative complications between the two groups (P0.05); compared with HRA group, THA group had shorter operation time (P0.0001) and less bleeding (P0. 02). Conclusion: HRA has a slight advantage in pain score in one year after operation. The quality of life score of THA at 6 months after operation is better than that of HRA, but there is no significant difference between the two groups in other follow-up periods. There was no significant difference in functional score, revision rate and complication rate between the two groups. The operative time and bleeding in HRA were more than those in THA.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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