同期与分期双膝关节置换术后死亡率的Meta分析

被引：7

作者：

胡军

刘锋

吕征

王青

崔维顶

范卫民

机构：

[1] 南京医科大学第一附属医院骨科

来源：

中华骨科杂志 | 2011年 / 08期

关键词：

关节成形术,置换,膝; 手术后并发症; 死亡率; Meta分析;

D O I：

暂无

中图分类号：

R687.4 [关节手术];

学科分类号：

1002 ; 100210 ;

摘要：

目的比较同期双膝关节置换术与分期双膝关节置换术的术后死亡率,评价同期与分期双膝关节置换术的安全性。方法参照Cochrane协作网(cochrane musculoskeletal group)建议的检索策略,计算机检索PubMed(1990至2010年)、OVID MEDLINE(1990至2010年)和Cochrane图书馆查找有关同期双膝关节置换术与分期双膝关节置换术术后并发症的临床研究。英文检索词包括:bilateraltotal kneearthroplasty、staged total knee arthroplasty、total knee arthroplasty等。由两名评价者独立选择实验,提取有效数据,采用Stata 10.0软件进行Meta分析。结果最终纳入6篇文献,同期双膝关节置换术组死亡率[OR=2.925,95%CI(2.352,3.638)]、30天死亡率[OR=5.078,95%CI(2.192,11.763)]及高龄患者(年龄>70岁)死亡率[OR=4.087,95%CI(1.947,8.582)]与分期双膝关节置换术组相比,均明显增高。结论现有的有限证据表明,同期双膝关节置换术术后死亡率高于分期双膝关节置换术。对于术前存在高风险(如高龄)的患者,宜考虑采用分期双膝关节置换术,慎重选择同期双膝关节置换术,并应充分评估手术风险,积极预防术后并发症的发生。受纳入文献数量和质量的限制,Meta分析结果尚有待于高质量的大样本随机对照试验以予证实。

引用

共 6 条

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