【摘要】：目的:通過Meta分析方法比較rhBMP-2復(fù)合體與自體髂骨塊(ICBG)在融合率及臨床療效方面的差異。方法:通過檢索2000年1月—2016年12月PUBMED、MEDLINE、EMBASE、Cochrane圖書館、相關(guān)期刊論文等數(shù)據(jù)庫以及人工檢索中、英文已發(fā)表文獻(xiàn)中的關(guān)于rhBMP-2復(fù)合體與ICBG施行腰椎椎間融合術(shù)治療成人單節(jié)段腰椎退行性病變的隨機(jī)對照試驗(yàn)研究文獻(xiàn)。篩選符合納入標(biāo)準(zhǔn)的相關(guān)文獻(xiàn),評(píng)價(jià)納入研究的方法學(xué)質(zhì)量。比較內(nèi)容包括:手術(shù)時(shí)間、術(shù)中出血量、住院時(shí)間、融合失敗率、ODI較術(shù)前恢復(fù)情況、二次手術(shù)數(shù),應(yīng)用RevMan5.0進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:根據(jù)納入標(biāo)準(zhǔn),共篩選出6篇文獻(xiàn)共計(jì)577例患者。6篇文獻(xiàn)方法學(xué)質(zhì)量較高(≥6分)。Meta分析表明,rhBMP-2復(fù)合體能夠顯著縮短手術(shù)及住院時(shí)間、降低出血量、減少二次手術(shù)風(fēng)險(xiǎn)。術(shù)后24個(gè)月rhBMP-2復(fù)合體組融合失敗率顯著低于ICBG組。術(shù)后24個(gè)月ODI評(píng)分提高不明顯病例的比例rhBMP-2復(fù)合體組少于ICBG組,但無統(tǒng)計(jì)學(xué)意義。根據(jù)手術(shù)入路不同進(jìn)行亞組分析,除住院時(shí)間異質(zhì)性較大,其余指標(biāo)均得到相同結(jié)果。結(jié)論:rhBMP-2用于治療單節(jié)段腰椎退行性病變,其中遠(yuǎn)期椎間融合率明顯優(yōu)于自體髂骨移植,并且前者可明顯縮短手術(shù)及住院時(shí)間、降低出血量、減少二次手術(shù)風(fēng)險(xiǎn)。初步證明rhBMP-2復(fù)合體在進(jìn)行腰椎椎間融合時(shí)的有效性以及對自體髂骨的替代作用。
[Abstract]:Objective: to compare the fusion rate and clinical efficacy between rhBMP-2 complex and autogenous iliac bone graft (ICBG) by Meta analysis. Methods: from January 2000 to December 2016, PUBMED,MEDLINE,EMBASE,Cochrane library, full text database of Chinese periodicals and manual retrieval were searched. A randomized controlled trial study on the treatment of single segment lumbar degenerative lesions with rhBMP-2 complex and ICBG intervertebral fusion in adults has been published. Select relevant documents that meet the inclusion criteria and evaluate the methodological quality of the included studies. The comparison included operation time, intraoperative bleeding volume, hospitalization time, fusion failure rate and recovery rate. The number of secondary operations was statistically analyzed by RevMan5.0. Results: according to the inclusion criteria, a total of 6 articles were selected in 577 patients with high methodological quality (鈮，

本文編號(hào)：2212725