本文選題：跟骨骨折 + 關(guān)節(jié)內(nèi)　； 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:本課題采用Cochrane協(xié)作網(wǎng)推薦的Mata分析方法對植骨與非植骨治療移位型跟骨關(guān)節(jié)內(nèi)骨折的隨機對照試驗進行系統(tǒng)評價,旨在比較移位型跟骨關(guān)節(jié)內(nèi)骨折術(shù)中植骨與否對治療效果的影響,以期為臨床跟骨骨折治療方法的選擇提供理論依據(jù)。方法:計算機檢索Pub Med(1954~2015.3)、EMbase(1954~2015.3)、The Cochrane Library、CNKI(1979~2015.3)、VIP(1989~2015.3)、CBM(1954~2015.3)和Wan Fang Data(1998~2015.3)等,查找對移位型跟骨關(guān)節(jié)內(nèi)骨折術(shù)中植骨與不植骨進行療效比較的隨機對照試驗及病例對照研究。按照Cochrane協(xié)作網(wǎng)的標(biāo)準(zhǔn),由2名評價者依據(jù)事先制定的納入和排除標(biāo)準(zhǔn)獨立篩選文獻。對納入的研究進行質(zhì)量評價、提取數(shù)據(jù)、資料,采用Rev Man 5.2版軟件對有效數(shù)據(jù)進行Meta分析。結(jié)果:最終共納入16篇文獻,16個臨床研究,1299例患者,其中植骨組769例,未植骨組530例。Meta分析結(jié)果顯示:在所有結(jié)局指標(biāo)中,足功能優(yōu)良率[OR=2.12,95%CI(1.57,2.86),P0.00001],B?hler角丟失[MD=-2.66,95%CI(-3.04,-2.27),P0.00001],植骨組優(yōu)于未植骨組;Gissane角丟失[SMD=-0.39,95%CI(-1.39,0.61),P=0.45]、跟骨高度降低[MD=-0.53,95%CI(-2.19,1.14),P=0.54],植骨組與未植骨組間差異無統(tǒng)計學(xué)意義。結(jié)論:對于移位型跟骨關(guān)節(jié)內(nèi)骨折患者術(shù)中給予骨移植能夠提高患者術(shù)后足功能優(yōu)良率,從而改善患者的生活質(zhì)量。
[Abstract]:Objective: to evaluate the randomized controlled trial of displaced intra-articular calcaneal fractures with or without bone graft by using the Mata analysis method recommended by Cochrane Cooperative Network in the treatment of displaced intra-articular calcaneal fractures. The purpose of this study was to compare the effect of intraarticular calcaneal fracture with or without bone graft in order to provide a theoretical basis for the treatment of calcaneal fracture. Methods: Pub Medal was searched by computer for the results of randomized controlled trial and case control study on the effect of bone grafts in displaced and intra-articular fractures during bone grafting and non-bone grafting during the operation of displaced and intra-articular fractures. The results were compared with those of the patients with displaced intraarticular fractures. The results were compared with those of the patients without bone grafts during the operation of the displaced type of bone fractures. The results were compared with those of the patients without bone graft during the operation of the displaced type of intra-articular fractures. The results were compared with those of the two groups. According to the standards of Cochrane collaboration, two reviewers independently sift the literature according to the pre-established inclusion and exclusion criteria. The quality of the included research was evaluated, the data was extracted, and the effective data was analyzed by Meta with Rev Man 5.2 software. Results: a total of 16 articles were included, 16 clinical studies were conducted in 1299 patients, including 769 cases in the bone graft group and 530 cases in the ungrafted group. The results of meta-analysis showed that: among all the outcome indicators, The excellent and good rate of foot function [OR2.1295CII 1.572.86 / P0.00001] the loss of BHler angle [MD-2.66-95CI-3.04CI-2.27CI-P0.00001], the bone graft group was superior to the non-grafted group in Gissane angle loss [SMD-0.399CI-1.399CI-1.390.661P0.45], the calcaneal height decreased [MD-0.5395CI-2.19395CI-2.191.14Pnu 0.54], there was no significant difference between the bone graft group and the non-grafted group. Conclusion: for the patients with displaced intra-articular calcaneal fracture, bone transplantation during operation can improve the excellent and good rate of postoperative foot function and improve the quality of life of the patients.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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本文編號：1893594