目的 分析急性髌骨脱位患者手术治疗和非手术治疗的临床效果。方法 计算机检索 PubMed、Embase、Springer、Cochrane 图书馆、中国知网、谷歌学术等数据库(建库至2018年10月)中比较非手术和手术治疗急性髌骨脱位的临床随机对照研究,经过严格的质量评价后使用 RevMan 5.3软件进行Meta分析。临床指标为Kujala评分、脱位复发率、再次手术率。结果 共纳入10篇文献。Meta分析结果显示:急性髌骨脱位两种治疗方法在Kujala 评分和再次手术率方面差异无统计学意义,手术治疗组脱位复发率在短期随访组(RR=2.87,95% CI:1.75～4.69,P＜0.0001)和长期随访组(RR＝1.80,95% CI:1.62~3.03,P＝0.03)均低于非手术治疗组。结论 手术治疗急性髌骨脱位较非手术治疗不易复发;两组疗效在Kujala评分、再次手术率方面差异无统计学意义。
Abstract
Objective To compare the effectiveness of surgery with a non-surgical approach in the treatment of acute patellar dislocation by meta-analysis, and to help select the right clinical approach to acute patellar dislocation.Methods We searched PubMed, Embase, Springer, Cochrane Library, China HowNet and Google Academy for randomized controlled trials related to conservative approaches to and surgical treatment for acute patellar dislocation in the database (from database inception to October 2018). Meta-analysis was conducted using RevMan 5.3 software after rigorous quality evaluation. Clinical indicators included the Kujala score, dislocation recurrence rate and reoperation rate.Results A total of 10 pieces of literature were included. The results showed that the Kujala score and reoperation rate were not of statistical significance. The recurrence rate of dislocation in the surgical treatment group was lower than that of the conservative treatment group both in the short-term follow-up group (RR=2.87, 95% CI:1.75-4.69,P<0.0001)and in the long-term follow-up group(RR=1.80, 95% CI:1.62-3.03,P=0.003).Conclusions Surgical treatment is less likely to lead to relapse than conservative treatment,but there is no significant difference in the Kujala score or reoperation rate between the conservative treatment group and surgical treatment group.
关键词
急性髌骨脱位 /
非手术治疗 /
手术治疗 /
Meta分析
Key words
acute patellar dislocation /
non-surgical /
surgery /
meta analysis
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参考文献
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基金
国家自然科学基金(30740089);武警部队项目(WHZ201607)
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