【摘要】 目的通过本次Meta分析比较我国老年人股骨转子间骨折使用髋关节置换与防旋股骨近端髓内钉(PFNA)治疗的疗效差异。方法计算机检索Pub Med、Cochrane、CNKI、万方、VIP等数据库,同时查阅相关骨科杂志等发表的文章。搜索关于PFNA与髋关节置换治疗国内高龄股骨转子间骨折的随机对照试验的文献,提取基线资料,采集手术时间、术中出血量、术后下地负重时间、住院时间、并发症、术后6个月Harris评分、术后12个月Harris评分等数据,并用Rev Man 5.30对所提取数据结果进行Meta分析处理。结果手术时间:P>0.05,差异无统计学意义,尚不能认为PFNA组与关节置换组在手术时间上有差别;术中出血量:P<0.05,差异有统计学意义,认为关节置换组术中出血量大于PFNA组;住院时间:P<0.05,差异有统计学意义,认为关节置换组住院时间小于PFNA组;术后下地负重时间:P<0.05,差异有统计学意义,认为关节置换组下地负重时间小于PFNA组;并发症:P<0.05,差异有统计学意义,认为关节置换组并发症的发生少于PFNA组;术后Harris评分(术后6个月):P<0.05,差异有统计学意义,关节置换组术后6个月Harris评分优于PFNA组;术后Harris评分(术后12个月):P<0.05,差异有统计学意义,关节置换组术后12个月Harris评分优于PFNA组。结论 PFNA术中出血量少于髋关节置换组。髋关节置换组住院时间、术后下地负重时间、并发症发生率、术后Harris评分优于PFNA组。更多还原

【Abstract】 Objective To compare the differences in the effects of proximal femoral nail antirotation and hip replacement on intertrochanteric fractures in the elderly by using a Meta-analysis. Methods The relevant literatures were searched in Pub Med, Cochrane, CNKI, Wanfang database and VIP, and other relevant journal for articles published. Randomized controlled trials concerning proximal femoral nail antirotation and hip replacement for the treatment of intertrochanteric fractures in the Chinese elderly were collected. Baseline data, operation time, intraoperative blood loss, postoperative out-of-bed time, length of stay, Harris score, complication rate were collected and processed using Rev Man 5.30 software for Meta analysis. Results The operation time, there was no statistically significant difference P<0.05, cannot think PFNA group and joint replacement had difference in operation time; Intraoperative blood loss: P<0.05, the difference was statistically significant, that joint replacement intraoperative blood loss was greater than the PFNA group; Length of hospital stay, P<0.05, the difference was statistically significant, argues that joint replacement in hospital time was less than PFNA group; The down load time: P<0.05, the difference was statistically significant, that joint replacement and down load time was less than PFNA group; Complications: P<0.05, the difference was statistically significant, that joint replacement complications was less than PFNA group; Postoperative Harris score(6 months): P<0.05, the difference was statistically significant, that joint replacement group 6 months postoperative Harris score was better than that of PFNA group; Postoperative Harris score(12 months): P<0.05, the difference was statistically significant, joint replacement group 12 months postoperative Harris score was better than that of PFNA group 12 months after surgery. Conclusions From the intraoperative blood loss, PFNA group was less than hip replacement. From the length of hospital stay, postoperative down load time, complications, and postoperative Harris score, hip replacement group was better than that of PFNA group.更多还原