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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:

2022年05期

页码:

304-312

栏目:

Meta分析

出版日期:

2022-10-05

文章信息/Info

Title:

Clinical efficacy of arthroscopic internal drainage with or without cystectomy in the treatment of popliteal cyst: a Meta-analysis

作者:

王薛丁1; 宋文杰1; 牛文杰1; 梁浩然1; 任智远1; 刘洋1; 马永胜1; 段王平2

030001 太原，山西医科大学第二临床医学院1；030001 太原，山西医科大学第二医院，骨与软组织损伤修复山西省重点实验室2

Author(s):

Wang Xueding1;  Song Wenjie1;  Niu Wenjie1;  Liang Haoran1;  Ren Zhiyuan1;  Liu Yang1;  Ma Yongsheng1;  Duan Wangpin2

1Department of Osteoarthritis, the Second Clinical Medical College of Shanxi Medical University, Taiyuan 030001, China; 2the Second Hospital of Shanxi Medical University, Key Laboratory of Bone and Soft Tissue Injury Repair of Shanxi Province, Taiyuan 030001, China

关键词:

腘窝囊肿;  关节镜;  囊壁切除;  临床疗效;  Meta分析

Keywords:

Popliteal Cyst;  Arthroscopy;  Cyst Wall;  Treatment Outcome;  Meta-Analysis

DOI:

10.3877/cma.j.issn.2096-0263.2022.05.009

文献标志码:

A

摘要:

目的 运用Meta分析的方法探讨比较关节镜下内引流联合或不联合囊壁切除两种术式治疗腘窝囊肿的临床疗效。方法 使用计算机检索PubMed、The Cochrane Library、EMBASE、中国知网和万方等数据库，检索时间从2016年08月到2021年08月，检索内容为关节镜下内引流联合或不联合囊壁切除治疗腘窝囊肿的临床对照研究。依据纳入标准及排除标准选取检索文献，然后采用Newcastle Ottawa Scale（NOS）文献质量评价量表及Cochrane手册中偏倚评估标准对纳入文献资料进行质量评估。应用Review Manager5.4软件对汇编的数据结果进行分析，比较关节镜下内引流联合或不联合囊壁切除两种术式治疗腘窝囊肿的临床疗效差异。结果 最终纳入9项研究，共494例患者，其中关节镜下内引流组256例，关节镜下内引流联合囊壁切除组248例。Meta分析结果显示：关节镜下单纯内引流组术后Lysholm评分［MD=-0.49，（95% CI：-2.09，1.11），P=0.55］、术后Rauschning-Lindgren分级［OR=0.54，（95% CI：0.28，1.04），P=0.06］及住院时间［MD=-0.29，（95% CI：-0.73，0.14），P=0.19］均与关节镜下内引流联合囊壁切除组无差异；内引流组术后并发症发生率低于囊壁切除组［OR=0.26，（95% CI：0.10，0.65），P=0.004］，内引流组手术时间［MD=-11.72，（95% CI：-13.69，-9.76），P＜0.01］及手术切口长度［MD=-5.94，（95% CI：-11.05，-0.83），P=0.02］均短于囊壁切除组，而囊壁切除组术后复发率则低于内引流组［OR=3.32，（95% CI：1.82，6.06），P＜0.01］，两者差异有统计学意义。结论 关节镜下内引流联合或不联合囊壁切除治疗腘窝囊肿临床结果都较满意，与关节镜下单纯内引流相比，联合囊壁切除术后复发率更低，但术后并发症的发生率较高、手术时间较长。

Abstract:

Objective Meta analysis was used to compare the clinical efficacy of arthroscopic internal drainage with or without cystectomy in the treatment of popliteal cyst. Methods The databases searched by computer include PubMed, EMBASE, The CochraneLibrary, Wanfang database, and China knowledge Network from August 2016 to August 2021. The search content is a clinical control study of arthroscopic internal drainage with or without cystectomy in the treatment of popliteal cysts. The literature was screened according to the inclusion criteria and exclusion criteria, and then the quality was evaluated for the included literature by NewcastleOttawaScale (NOS) literature quality evaluation scale and Cochrane manual bias evaluation criteria. After extracting the data, the data were analyzed by ReviewManager5.4 software to compare the clinical efficacy of arthroscopic internal drainage with or without cystectomy in the treatment of popliteal cyst. Results Finally, A total of 9 studies with 494 patients were included, including 256 cases of arthroscopic internal drainage group and 248 cases of arthroscopic internal drainage combined with cystectomy group. Meta-analysis showed that there was no difference in postoperative Lysholm score [MD=-0.49, (95%CI: -2.09,1.11), P=0.55], postoperative Rauschning and Lindgren grade [OR=0.54, (95%CI: 0.28,1.04), P=0.06] and hospitalization time [MD=-0.29, (95%CI: -0.73,0.14), P=0.19] between arthroscopic internal drainage group and arthroscopic internal drainage combined with cystectomy group. The incidence of postoperative complications in the internal drainage group was lower than that in the cyst wall resection group [OR=0.26, (95%CI: 0.10,0.65), P=0.004], the operation time [MD=-11.72, (95%CI: -13.69,-9.76), P<0.01] and incision length [MD=-5.94, (95%CI: -11.05,-0.83), P=0.02] in the internal drainage group were shorter than those in the cyst wall resection group, the postoperative recurrence rate [OR=3.32, (95%CI: 1.82, 6.06), P<0.01] in the cyst wall resection group was lower than that in the internal drainage group,and the difference in results between the two groups was statistically significant. Conclusion The clinical results of arthroscopic internal drainage combined with or without cyst wall resection in the treatment of popliteal cysts are satisfactory, but compared with arthroscopic internal drainage alone, the recurrence rate after arthroscopic internal drainage combined with cystectomy is relatively low, but the incidence of postoperative complications is relatively high and the operation time is relatively long.

备注/Memo

备注/Memo:

基金项目：山西省重点研发计划项目（201903D421019）

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更新日期/Last Update: 2022-10-31