【摘要】 [目的]系统评价新鲜无移位舟骨腰部骨折手术与非手术治疗的效果。[方法]计算机检索MEDLINE、EMBASE、PubMed、SpringerLi、Cochrane Library、中国生物医学文献数据库、中国知网、国家科技图书文献中心等数据库(1982年1月~2012年5月),手工检索相关杂志,制定纳入排除标准,收集相关的随机对照试验(random contrast trial,RCT),对纳入的研究进行方法学质量评价和资料提取后,采用RevMans.5软件进行Meta分析。[结果]共9篇RCT研究类型的论文纳入本研究,共计501例患者,Meta分析显示手术组患者的骨折愈合时间、重返工作时间较石膏组患者短(P<0.000 1),骨折不愈合率比石膏组患者(P=0.00 2)低,手术组患者腕关节活动度、握力恢复较石膏组患者差(P<0.000 01),手术组患者的并发症与石膏组患者相比无明显差别(P=0.74)。[结论]手术治疗急性舟骨骨折与保守治疗相比较分别有各自的优势,应综合考虑患者客观情况和主观愿望决定采用何种治疗:对于急于重返工作或生活中难以长期维持外固定的患者则可首先考虑手术治疗。更多还原

【Abstract】 [Objective]To evaluate the different treatment effectiveness of fresh nondisplaced scaphoid waist fracture,by Meta- analysis of the literature published at home and abroad as well as to compare the clinical cases.[Method]Stusies of all randomized controlled trials( randomized controlled trials,RCT) published both at home and abroad in 1982 Junary ~ 2012 May on comparison between surgery and nonoperative treatment effect of fresh unplaced scaphoid waist fracture were indentified from MEDLINE,EMBASE,PubMed,Cochrane Library,the Chinese Biomedical Literature Database( CBM),Chinese HowNet( CNKI),the National Science and Technology Library. After the methodological quality assessment and data extraction of the included studies,RevMans. 5 Software was used for Meta- analysis.[Result]Nine RCT type of research papers were brought into Meta analysis study,including a total of 501 patients( 250 of operation group and 251 of nonoperation group). The meta- analysis showed that fracture union time and time off work of the surgery group were shorter than the immobilization group( P < 0. 0001),the wrist joint activities and grip strength of the surgical group are worse than immobilization group( P < 0. 00001),nonunion rate of the surgical group( P = 0. 002) was lower than the immobilization group,and the surgical complications compared with immobilization group had no obvious difference( P = 0. 74).[Conclusion]Conservative treatment and operation compared respectively have their own advantages. The patient’s objective circumstances and wishes should be considered to decide what kind of treatment would be taken. Operation can be prior suggested to the patients who are eager to return to work or hard to maintain with external fixation for a long time in life.更多还原