江汉大学学报(自然科学版) ›› 2018, Vol. 46 ›› Issue (1): 77-82.doi: 10.16389/j.cnki.cn42-1737/n.2018.01.015

• 医学 • 上一篇    下一篇

经皮球囊扩张椎体后凸成形术与保守治疗骨质疏松性椎体压缩性骨折的Meta 分析

苏其昌1,张汉庆*2,王晓慧3   

  1. 1.江汉大学,湖北 武汉 430056;2.武汉市中医医院,湖北 武汉 430014;3.武汉市第五医院,湖北 武汉 430050
  • 出版日期:2018-02-28 发布日期:2018-02-03
  • 通讯作者: 张汉庆
  • 作者简介:苏其昌(1989—),男,硕士生,研究方向:外科学。

Comparisons of Percutaneous Kyphoplasty and Conservative Treatment on Osteoporosis Vertebra Compression Fracture:a Meta Analysis

SU Qichang1,ZHANG Hanqing*2,WANG Xiaohui3   

  1. 1.Jianghan University ,Wuhan 430056,Hubei,China;2. Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014,Hubei,China;3. Fifth Hospital in Wuhan,Wuhan 430050,Hubei,China
  • Online:2018-02-28 Published:2018-02-03
  • Contact: ZHANG Hanqing

摘要: 目 的 应用Meta 分析方法评价经皮球囊扩张椎体后凸成形术(PKP)与保守方法治疗骨质疏松性椎体压缩性骨折的疗效差异。方 法 计算机检索Pubmed、Cochrane Library、Embase、中国生物医学文献数据库(SinoMed)、中国知网(CNKI)、万方数据库(Wanfang Standards Database),检索日期至2017 年5 月,搜集关于经皮球囊扩张椎体后凸成形术与保守方法治疗骨质疏松性椎体压缩性骨折的随机对照试验。严格评价纳入研究的方法学质量并提取资料,统计软件采用RevMan5.3。结 果 共纳入6 篇随机对照试验文献,共475 例患者,PKP 组233 例,保守组242 例。根据改良后的Jadad 评分标准,有4 篇为高质量文献,2 篇为低质量文献,偏倚风险评估为中等。Meta分析显示,PKP组治疗后1周、1个月、3个月VAS疼痛评分低于保守组,差异具有统计学意义(P <0. 05),治疗后6个月、12个月VAS评分比较差异无统计学意义( P >0. 05)。治疗后3 d、3个月ODI功能障碍评分PKP组均少于保守组,差异具有统计学意义( P <0. 05)。结 论 经皮球囊扩张椎体后凸成形术后早期比保守治疗更能有效缓解疼痛,远期无明显差异,且前者治疗后可获得更好的功能恢复,建议临床推广应用。

关键词: 骨质疏松性椎体压缩性骨折, 经皮球囊扩张椎体后凸成形术, 保守治疗, Meta分析

Abstract: Objective To evaluate the therapeutic effect of percutaneous kyphoplasty(PKP)and conservative treatment for osteoporosis vertebra compression fracture with Meta analysis. Methods Pubmed,Cochrane Library,Embase,SinoMed,CNKI and Wanfang Standards Database were searched.The retrieval date was before May,2017. The data were percutaneous kyphoplasty and conservative treatment on osteoporosis vertebra compression fractures with a randomized controlled trial. The writer strictly evaluated the quality of the methodology incorporated into the study and extracted the data,with statistical software RevMan 5.3. Results A total of 6 randomized controlled trials with 475 cases were included,233 in the PKP group and 244 in the conservative treatment group. According to the improved Jadad score,four were high quality literature,two were low quality literature,and the bias risk assessment wasmoderate.Meta analysis results showed the VAS pain score of the PKP group was lower than that of the conservative treatment group at one week,one month and three months after treatment,which was statistically significant( P <0. 05 ).The differences were not statistically significant in VAS score at six months and 12 months after treatment( P >0. 05).After three days and three months of treatment,ODI dysfunction score in the PKP group was less than that in the conservative treatment group,with statistical significance( P <0. 05). Conclusion Percutaneous kyphoplasty is more effective in relieving pain than the conservative treatment in early stage and it is not significant different in long-term. Besides,the former treatment has a better function recovery,it is recommended for clinical application.

Key words: osteoporosis vertebra compression fracture, percutaneous kyphoplasty, conservative treatment, Meta analysis

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