[1]陈韬予,王少伟,王小健,等.经劈三角肌入路与经三角肌胸大肌入路治疗肱骨近端骨折临床疗效的Meta分析[J].中华老年骨科与康复电子杂志,2018,(06):360-368.[doi:10.3877/cma.j.issn.2096-0263.2018.06.009]
　Chen Taoyu,Wang Shaowei,Wang Xiaojian,et al.Deltoid-split approach versus deltopectoral approach in displaced proximal humeral fracture : A meta-analysis[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(06):360-368.[doi:10.3877/cma.j.issn.2096-0263.2018.06.009]
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经劈三角肌入路与经三角肌胸大肌入路治疗肱骨近端骨折临床疗效的Meta分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年06期
页码:
360-368
栏目:
Meta分析
出版日期:
2018-11-23

文章信息/Info

Title:
Deltoid-split approach versus deltopectoral approach in displaced proximal humeral fracture : A meta-analysis
作者:
陈韬予1; 2; 王少伟2; 王小健2; 韩鹏飞1; 3; 李鹏翠2; 卫小春2
030001 太原，山西医科大学第二医院骨与软组织损伤修复重点实验室1；骨科2；046000 长治市第二人民医院骨科3
Author(s):
Chen Taoyu1; 2;  Wang Shaowei2;  Wang Xiaojian2;  Han Pengfeng1; 3;  Li Pengcui2;  Wei Xiaochun2
1Key Laboratory of Bone and Soft Tissue Injury Repair, 2Department of Orthopaedic Surgery, Second Hospital of Shanxi Medical University, 3Department of Orthopaedic Surgery, Changzhi Second People’s Hospital, Taiyuan 030001, China
关键词:
肱骨骨折;  Meta分析;  手术入路
Keywords:
Humeral fractures;  Meta-analysis;  Surgical approach
DOI:
10.3877/cma.j.issn.2096-0263.2018.06.009
文献标志码:
A
摘要:
目的 通过Meta分析评测经劈三角肌入路与三角肌胸大肌肌间隙入路治疗肱骨近端移位骨折的临床疗效。方法 检索Pubmed、Embase、等知名数据库，辅以手工检索、文献追溯相关文献，收集2006年1月至2018年04月国内外已发表两种手术入路的对照研究文章。严格评价纳入研究的文献质量及提取相关数据资料，运用RevMan5.3软件统计分析相关数据行Meta分析。结果 纳入10项对照研究，共789例患者。结果分析显示：经劈三角肌入路和三角肌胸大肌入路在手术时间（95% CI：-26.56～9.77，P＜0.00001）、术中出血量（95% CI：-73.79～-19.54，P＜0.00001）、住院天数（95% CI：-1.35～-0.60，P＜0.00001）、术后3个月Constant评分（95% CI：4.38～6.92，P＜0.00001）、术后6个月日常生活能力量表（ADL）（95% CI：0.27～2.02，P=0.01）方面，差异均有统计学意义。术后6个月（95% CI：-1.66～6.74，P=0.24）、12月Constant评分（95% CI：-7.01～7.73，P=0.92）、术后12个月ADL（95% CI：-0.18～1.49，P=0.12）、上肢功能评分（DASH）（95% CI：-4.91～2.47，P=0.52）、并发症（95% CI：0.55～1.34，P=0.51）等方面差异无统计学意义。结论 经劈三角肌入路手术时间更短、术中出血量更少、住院时间减短、术后早期功能恢复更好。但在并发症发生率、晚期上肢功能等方面尚无足够证据证明其有明显差异。
Abstract:
Objective To compare the efficacy and safety of Deltoid-split approach versus Deltopectoral approach in the treatment of displaced proximal humeral fracture. Methods Articles compared two surgical approaches published in Embase, Pubmed, CNKI, Chinese Biomedical Database, Wanfang Data, Cochrane Library and other well-known databases were retrieved from January 2006 to April 2018. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.3 was used for data-analysis. Results A total of 789 patients in 10 controlled studies were included in the meta-analysis. Results showed statistical significance were found in the operation time (95% CI: -26.56-9.77, P<0.00001), intraoperative blood loss (95% CI: -73.79--19.54, P＜0.00001], length of hospital stay (95% CI: -1.35--0.60, P<0.00001), constant score 3 month after operation (95% CI: 4.38-6.92, P<0.00001), Activity of daily living (ADL) 6 month and 12 month after operation (95% CI: 0.27-2.02, P=0.01) between two approaches. The constant score at 6 months (95% CI: -1.66-6.74, P=0.24) and 12 months after operation (95% CI: -7.01-7.73, P=0.92), 12 months postoperative ADL (95% CI: -0.18-1.49, P=0.12), DASH (95% CI: -4.91-2.47, P=0.52, complications (95% CI: 0.55-1.34, P=0.51) were not statistically significant. Conclusions The Deltoid-split approach is superior to the deltopectoral approach in the treatment of displaced proximal humeral fracture regards to the operation time, blood loss, length of hospital stay, union time. But there is not enough evidence on the incidence of complications, long term limb function and other aspects.

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备注/Memo

备注/Memo:
基金项目：山西省骨关节炎生物学样本资源共享服务平台建设基金（201705D121010）
更新日期/Last Update: 2018-11-23