發(fā)布時間：2018-03-08 21:17

  本文選題：脊柱骨折　切入點：骨折　出處：《中國組織工程研究》2017年02期 　論文類型：期刊論文

【摘要】：背景:椎體成形系統(tǒng)修復(fù)骨質(zhì)疏松性椎體壓縮性骨折的療效已得到肯定,但骨水泥滲漏導(dǎo)致的相關(guān)并發(fā)癥仍時有發(fā)生。根據(jù)滲漏因素分析所產(chǎn)生的高黏度骨水泥安全性和有效性高,但缺乏大樣本、高強度的證據(jù)研究。目的:系統(tǒng)評價高黏度與普通黏度骨水泥椎體成形系統(tǒng)修復(fù)椎體壓縮性骨折的安全性和有效性。方法:計算機檢索Pub Med、Embase、Cochrane Library、中國知網(wǎng)、維普及萬方數(shù)據(jù)庫等,檢索時間均為各數(shù)據(jù)庫自建庫以來至2016年1月,收集關(guān)于高黏度骨水泥與普通黏度對比修復(fù)椎體壓縮性骨折的隨機或臨床對照研究。由2名研究員根據(jù)Cochrane系統(tǒng)評價的方法獨立對納入研究的文獻質(zhì)量進行評價并提取數(shù)據(jù),采用Rev Man 5.2軟件進行數(shù)據(jù)分析。結(jié)果與結(jié)論:1納入4個隨機對照試驗,6個臨床對照試驗;2Meta分析結(jié)果顯示,與普通骨水泥相比,高黏度骨水泥在注射劑量[MD=0.17,95%CI(-0.04,0.38)]、目測類比評分[隨機對照試驗:MD=-0.30,95%CI(-0.72,0.11);臨床對照試驗:MD=-0.05,95%CI(-0.43,0.32)]以及術(shù)后椎體再骨折[OR=1.77,95%CI(0.24,12.86)]方面,差異均無顯著性意義;但高黏度骨水泥組術(shù)后Oswestry功能障礙指數(shù)降低更明顯[MD=-2.99,95%CI(-5.85,-0.13)],Cobb角恢復(fù)更佳[MD=-3.19,95%CI(-5.27,-1.10)],骨水泥滲漏率更低[OR=0.35,95%CI(0.24,0.51)],差異有顯著性意義;3與普通黏度骨水泥相比,高黏度骨水泥椎體成形在恢復(fù)脊柱功能、生理結(jié)構(gòu)以及減少滲漏方面更具優(yōu)勢。鑒于研究樣本量小、異質(zhì)性高,結(jié)論仍需大樣本、高質(zhì)量的隨機對照試驗予以論證。
[Abstract]:Background: the efficacy of vertebroplasty system in the repair of osteoporotic vertebral compression fractures has been confirmed. However, complications associated with bone cement leakage still occur from time to time. The high viscosity bone cement produced by seepage factor analysis has high safety and effectiveness, but lacks large samples. Objective: to systematically evaluate the safety and effectiveness of high viscosity and common viscosity bone cement vertebroplasty system in the repair of vertebral compression fractures. Methods: Pub Medsite Embase Cochrane Library, China knowledge Web, Wiper and Wanfang databases were searched by computer. The retrieval time is from the time since the database was built to January 2016. A randomized or clinical controlled study was collected on the repair of vertebral compression fractures with high viscosity bone cement compared with ordinary viscosity. Two researchers independently evaluated the quality of literature included in the study and extracted data according to the Cochrane system evaluation method. Rev Man 5.2 software was used to analyze the data. Results and conclusions: 1 was included in 4 randomized controlled trials. There was no significant difference in the injection dose of high viscosity bone cement (MD0.1795 CI-0.04 0.38) and visual analogy score (MD-0.3095CI-0.72CI-0.72CI-0.11 in randomized controlled trial; clinical control trial: MD-0.05 ~ 95CI-0.430.32) and the postoperative vertebral body refracture [OR1.77-95CI0.240.2412.86]. However, in the high viscosity cement group, the Oswestry dysfunction index decreased more significantly after operation [MD-2.99 ~ 95% CI-5.85 ~ 0.13] [MD-3.1995 ~ 95 CI-5.27 ~ 1.10], and the leakage rate of bone cement was lower [OR0.3595CI0.240.51]. The difference was significant compared with the normal viscosity cement. In view of the small sample size and high heterogeneity, the conclusion still needs a large sample and a high quality randomized controlled trial to prove it.
【作者單位】： 廣西壯族自治區(qū)人民醫(yī)院骨科;
【分類號】：R687.3;R580

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