本文選題：胸腰椎爆裂骨折不伴神經(jīng)損傷　切入點：保守治療　出處：《中國矯形外科雜志》2017年02期 　論文類型：期刊論文

【摘要】：[目的]系統(tǒng)評價保守和手術(shù)治療不伴神經(jīng)損傷的胸腰椎爆裂骨折的有效性和安全性差異。[方法]計算機(jī)檢索Pubmed、Embase、Cochrane圖書館、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)、萬方數(shù)據(jù)及中國知網(wǎng)等6個常用的中英文電子數(shù)據(jù)庫,收錄有關(guān)保守和手術(shù)治療不伴神經(jīng)損傷的胸腰椎爆裂骨折的臨床隨機(jī)對照研究,檢索文獻(xiàn)截至2015年9月。按照納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)限定研究對象,采用改良的Jadad評分量表進(jìn)行文獻(xiàn)質(zhì)量評估,運(yùn)用RevMan 5.3軟件對提取的有效數(shù)據(jù)進(jìn)行Meta分析。[結(jié)果]納入4項臨床隨機(jī)對照研究,共計患者239人,最終完成隨訪212人,其中保守組112例,手術(shù)組100例,隨訪12~268個月。Meta分析顯示無論接受保守還是手術(shù)治療的患者,在治療后疼痛感受(VAS評分)、功能恢復(fù)(RMDQ-24)及重返工作方面比較差異均無統(tǒng)計學(xué)意義,但手術(shù)組患者后凸畸形的改善明顯優(yōu)于保守組,而保守組在治療后的并發(fā)癥和醫(yī)療花費方面要優(yōu)于手術(shù)組。[結(jié)論]對于不伴神經(jīng)損傷的胸腰椎爆裂骨折無論是保守還是手術(shù)治療,兩者的中遠(yuǎn)期臨床結(jié)果相似,保守治療具有并發(fā)癥低、醫(yī)療花費少等優(yōu)勢。但由于各研究起始年月較早,手術(shù)方式較為傳統(tǒng),近年來興起的微創(chuàng)治療等手段與保守治療的對比尚需更多高質(zhì)量的前瞻臨床對照研究進(jìn)一步增強(qiáng)循證依據(jù)。
[Abstract]:[objective] to evaluate the efficacy and safety of conservative and surgical treatment of thoracolumbar burst fractures without nerve injury. [methods] Pubmedmedus Embase Cochrane Library was searched by computer. The Chinese Biomedical Literature Database (CBMX), Wanfang data and China Zhiwang are six commonly used electronic databases in both Chinese and English, which include clinical randomized controlled studies on conservative and surgical treatment of thoracolumbar burst fractures without nerve injury. As of September 2015, according to the inclusion criteria and exclusion criteria, the literature quality was evaluated by the modified Jadad scoring scale. The effective data were analyzed by Meta using RevMan 5.3 software. [results] in 4 randomized controlled clinical trials, a total of #number0# patients were followed up, including 112 cases in conservative group and 100 cases in operation group. Follow-up analysis of 12 ~ 268 months. Meta-analysis showed that there was no significant difference in VAS scores, functional recovery and RMDQ-24) and return to work in patients who received conservative or surgical treatment after treatment. But the improvement of kyphosis in operation group was better than that in conservative group. But the conservative group is superior to the surgical group in terms of complications and medical cost after treatment. [conclusion] for thoracolumbar burst fracture without nerve injury, the middle and long term clinical results of both groups are similar, whether conservative or surgical. Conservative treatment has the advantages of low complications and less medical cost. However, due to the early onset of each study, the operation method is more traditional. The comparison between minimally invasive therapy and conservative therapy in recent years requires more high-quality prospective clinical controlled studies to further strengthen the evidence-based evidence-based evidence-based evidence-based evidence-based evidence-based study.
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本文編號：1573254