發(fā)布時(shí)間：2018-06-16 12:57

  本文選題：股骨轉(zhuǎn)子間骨折 + 中老年人��； 參考：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:對(duì)防旋型股骨近端髓內(nèi)釘(PFNA)與Gamma3型髓內(nèi)釘治療中老年股骨轉(zhuǎn)子間骨折治療療效進(jìn)行meta分析。方法:運(yùn)用計(jì)算機(jī)檢索Pubmed、Cochrane圖書館數(shù)據(jù)庫、AO/ASIF數(shù)據(jù)庫、相關(guān)期刊論文(CNKI)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫(VIP)等,手工檢索與骨科相關(guān)的會(huì)議論文等。收集PFNA與Gamma3釘治療中老年人股骨轉(zhuǎn)子間骨折的隨機(jī)對(duì)照研究(Randomized Controlled Trial,RCT)和回顧性隊(duì)列研究(Retrospective Cohort Study,RCS)。依據(jù)納入與排除符合選取要求的文獻(xiàn)、提取相關(guān)數(shù)據(jù)。選取手術(shù)時(shí)間、術(shù)中失血量、下床負(fù)重時(shí)間、術(shù)后TAD值、切口長(zhǎng)度、Harris評(píng)分優(yōu)良率、骨折愈合時(shí)間、術(shù)后并發(fā)癥作為Meta分析評(píng)價(jià)指標(biāo),使用Cochrane制作的Review Manager 5.3進(jìn)行Meta分析。結(jié)果:共有12篇文獻(xiàn)納入研究Meta分析結(jié)果,共1382例患者,其中PFNA內(nèi)固定727例,Gamma3釘內(nèi)固定655例。與Gamma3型釘組相比,PFNA組具有手術(shù)時(shí)間短、出血量少、術(shù)后TAD值小,但兩者在住院時(shí)間、骨折愈合時(shí)間、髖關(guān)節(jié)功能Harris評(píng)分、術(shù)后優(yōu)良率及并發(fā)癥等方面比較,差異無顯著統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:所檢索的文獻(xiàn)表明PFNA內(nèi)固定較Gamma3型釘內(nèi)固定治療中老年股骨轉(zhuǎn)子間骨折能有效縮短手術(shù)時(shí)間、減少術(shù)中失血量、術(shù)后TAD值,但在住院時(shí)間、骨折愈合時(shí)間、髖關(guān)節(jié)Harris評(píng)分、術(shù)后優(yōu)良率及并發(fā)癥方面差異不存在統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective: to evaluate the efficacy of anti-rotation intramedullary nailing (PFNA) and Gamma3 type intramedullary nail in the treatment of intertrochanteric fractures of the femur. Methods: the online database of Pubmedan Cochrane Library (AOP / Asif), the full text Database of Chinese Journals (CNKII), Wanfang Database and Weip Database were searched by computer, and the related conference papers of orthopedics were searched by hand. A randomized controlled RCT study of PFNA and Gamma3 nail for the treatment of femoral intertrochanteric fractures in the elderly and retrospective cohort study was conducted. According to the inclusion and exclusion of the selected documents, extract the relevant data. The operative time, blood loss, weight loading time, TAD value, incision length and Harris score, fracture healing time and postoperative complications were selected as Meta-analysis index. Cochrane's Review Manager 5.3 was used for Meta-analysis. Results: a total of 12 literatures were included in the Meta-analysis of 1382 patients, including 727 cases of internal fixation with Gamma3 nail and 655 cases with internal fixation of Gamma3 nail. Compared with Gamma3 nail group, PFNA group had shorter operation time, less bleeding and lower TAD value after operation. However, the hospitalization time, fracture healing time, Harris score of hip function, postoperative excellent and good rate and complications were compared between PFNA group and Gamma3 nail group. The difference was not significant (P 0.05). Conclusion: compared with Gamma3 nail internal fixation, PFNA can effectively shorten the operation time, reduce the amount of blood loss during operation and the TAD value after operation, but the time of hospitalization and fracture healing can be improved by using PFNA in the treatment of intertrochanteric fracture of femur. There was no significant difference in Harris score, excellent and good rate and complications.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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本文編號(hào)：2026777