手术治疗跟骨骨折并发症的Meta分析

被引:57
作者
刘新成
陈雁西
俞光荣
机构
[1] 同济大学附属同济医院骨科
关键词
跟骨; 骨折; 手术后并发症; Meta分析;
D O I
暂无
中图分类号
R687.3 [骨骼手术];
学科分类号
100220 [骨科学];
摘要
目的采用循证医学研究方法,评价跟骨骨折术后各种并发症的发生情况,为临床治疗策略提供依据。方法检索过去20年手术治疗跟骨骨折的相关文献。数据库包括Medline(1 989-2008)、Cochrane Database(1989-2008)、Embase Database(1 989-2008)、Science Direct(1989-2008)等。再根据具体的纳入标准,对检索出的文献及其参考文献行手工检索,对入选文献行数据汇总,采用SPSS 14.0及RevMan 5分析软件进行荟萃分析。结果根据预设检索条件,共检索出1 823篇关于跟骨骨折的原始文献,经过筛选和评价,最后收集到29篇临床研究报道符合本次Meta分析的纳入标准。上述研究共计2 661例患者(2 800侧患足),提供了患者术后并发症情况及处理方法的信息。数据分析结果提示,跟骨骨折术后主要并发症包括术后感染[发生率=8.6%,95%可信区间(CI)7.53~9.61]、创口边缘坏死(发生率=2.6%,95%CI 2.05~3.24)、创伤后关节炎(发生率=2.0%,95%CI 1.42~2.44)、腓骨肌腱炎(发生率=1.3%,95%CI0.84~1.66)、神经血管损伤(发生率=1.2%,95%CI 0.81~1.62)、跟骨骨髓炎(发生率=1.0%,95%CI 0.60~1.33)、骨不连(发生率=0.2%,95%CI 0.04~0.39)、骨折复位不良(发生率=0.1%)和内固定物问题(发生率=0.7%,95%CI 0.4~1.03)。结论跟骨骨折术后并发症较常见,临床医师应正确认识并尽早予以干预,可取得较理想的疗效。
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