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高龄患者肱骨近端3、4部分骨折手术与非手术治疗疗效比较的Meta分析
Comparison of curative effect between operation and nonoperative treatment of 3,4-part proximal humeral fracture in elderly patients: a Meta-analysis
  
DOI:
中文关键词:  肱骨近端骨折,手术治疗,非手术治疗,Meta 分析
英文关键词:Proximal humeral fractures,Operation,Nonoperation,Meta-analysis
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作者单位
李强 刘瑞 路全立 任海鹏 甄志龙 赵建民* 内蒙古医科大学附属医院骨科内蒙古 
通讯作者:李强 刘瑞 路全立 任海鹏 甄志龙 赵建民*  内蒙古医科大学附属医院骨科,内蒙古  
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中文摘要:
      [摘要]目的 通过Meta分析对高龄患者肱骨近端3、4部分骨折手术与非手术治疗的疗效进行评价,以期为临床上治疗方式的选择提供参考。方法 通过计算机检索Medline、PubMed 、Embase、Cochrance图书馆、中国期刊全文数据库、万方数据库、维普中文科技期刊全文数据库等关于肱骨近端3、4部分骨折手术治疗与非手术治疗疗效比较的随机对照研究(RCT),检索时间均为建库至2014年7月,纳入符合标准的文献,比较两组患者Constant评分、后期再次手术治疗率及治疗并发症。提取相关数据输入RevMan 5.2软件进行统计学分析。结果 共5篇文献符合纳入标准,均为英文文献,经改良Jadad评分判定文献研究质量较高。Meta分析结果显示: 手术组与非手术组治疗后12个月Constant 评分(MD 值为2.99,95% 置信区间[-1.64, 7.61],P = 0.21),手术组与非手术组治疗后24个月以上Constant 评分(MD 值为-1.04,95% 置信区间[-7.59, 5.51],P = 0.76),两组患者在治疗后12个月及24个月以上Constant 评分比较差异均无统计学意义(P)0.05)。两组患者肱骨头坏死、骨不连、骨关节炎、肩峰撞击及关节僵硬发生率方面比较差异均无统计学意义(P)0.05),而在再手术率方面比较差异有统计学意义(P<0.05)。结论 据Meta分析的结果,高龄患者肱骨近端3、4部分骨折手术治疗与非手术治疗在疗效、并发症等方面无明显差异,因此非手术治疗可作为临床上治疗高龄患者移位的肱骨近端骨折的一种选择。
英文摘要:
      [Abstract] Objective To assess the curative effect to 3,4-part proximal humeral fractures between operation or nonoperative treatment in elderly patients by Meta-analysis. Method RCTs comparing operation and nonoperative treatment for 3,4-part proximal humeral fracture in elderly patients before July 2014 were identified from the Medline,PubMed, Embase,Cochrance Library,CNKI,Wan Fang and VIP database through computer search. The eligible RCTs were collected,Then the data were extracted and a Meta-analysis was made using RevMan5.2 and STATA.Result Five articles were accepted in this Meta-analysis and all of them were high quality researches by modified Jadad Scale. The combined MD of constant score at 12 months postoperatively was 2.99 between operation group and nonoperation group,(95% confidence interval(CI) [-1.64, 7.61],P = 0.21). The combined MD of constant score at more than 24 months postoperatively was -1.04 between operation group and nonoperation group,(95% confidence interval(CI)[-7.59, 5.51],P = 0.76). there was no significant difference between operation group and nonoperation group in complication(P>0.05),but there was significant difference in reoperation rate(P<0.05). Conclusion Our meta-analysis concluded that there was no significant difference between operation group and nonoperation group in curative effect to 3,4-part proximal humeral fractures in elderly patients,so nonoperative treatment is a choice for 3,4-part proximal humeral fracture in elderly patients
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