【摘要】：目的:對(duì)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(píng)價(jià)。比較兩種術(shù)式的差異,以更好的指導(dǎo)臨床工作。方法:計(jì)算機(jī)檢索MEDLINE、EMBASE、Cochrane協(xié)作網(wǎng)數(shù)據(jù)庫(kù),檢索時(shí)間為數(shù)據(jù)庫(kù)建立到2016年6月。國(guó)內(nèi)骨科雜志和有關(guān)會(huì)議資料采用人工方法檢索。挑選有關(guān)的隨機(jī)對(duì)照試驗(yàn)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(píng)價(jià)和數(shù)據(jù)統(tǒng)計(jì)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(píng)分差異有統(tǒng)計(jì)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(gè)月、2年、5年的評(píng)分無(wú)明顯差異(P0.05)。THA組術(shù)后6個(gè)月的SF-36生活質(zhì)量評(píng)分較HRA組高,其余隨訪時(shí)間段內(nèi)無(wú)明顯差異。兩組在術(shù)后Harris功能評(píng)分、翻修率和術(shù)后并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);與HRA組對(duì)比,THA組手術(shù)時(shí)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(píng)分方面稍占優(yōu)勢(shì),THA術(shù)后6個(gè)月的生活質(zhì)量評(píng)分優(yōu)于HRA,但在其他隨訪時(shí)間段內(nèi)兩組無(wú)明顯差異。兩組術(shù)后的功能評(píng)分、翻修率和并發(fā)癥發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義。HRA手術(shù)時(shí)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(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.4

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本文編號(hào)：2370863