华西医学

华西医学

骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症发生的 Meta 分析

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目的通过 Meta 分析比较骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症的发生情况。方法检索 Cochrane 图书馆、Embase、PubMed、中国生物医学文献数据库、维普中文科技期刊数据库、中国知网、万方数据库,检索时间均为从建库至 2018 年 1 月,收集所有比较骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症发生情况的随机对照试验,比较两组术后伤口深部感染、浅表感染、肺部感染、尿道感染的发生情况。采用 RevMan 5.2.0 软件进行 Meta 分析。结果共纳入 11 篇随机对照研究,包括 1 533 例患者。Meta 分析结果显示:两组间术后伤口深部感染[比值比(odds ratio,OR)=1.62,95% 置信区间(confidence interval,CI)(0.66,3.94),P=0.29]、浅表感染[OR=1.17,95%CI(0.56,2.47),P=0.68]、肺部感染[OR=0.73,95%CI(0.47,1.13),P=0.16]、尿道感染[OR=1.10,95%CI(0.65,1.86),P=0.73]的发生率差异均无统计学意义。结论半髋关节置换治疗老年股骨颈骨折术中是否使用骨水泥,与术后感染相关并发症的发生无关。

ObjectiveTo systematically review the postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture.MethodsCochrane Library, PubMed, Embase, China Biology Medicine Database, Chongqing VIP China Science and Technology Journal Database, China National Knowledge Infrastructure, and Wanfang Database were searched to collect randomized controlled trials of postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture from inception to January 2018. A systematic review was performed to compare the postoperative deep infection, superficial wound infection, pneumonia infection, and urinary tract infection between cemented and cementless hemiarthroplasty. Analyses were conducted using Review Manager version 5.2.0 software.ResultsA total of 11 studies were included in the Meta-analysis, including 1 533 patients. There was no significant difference in the incidence of deep infection [odds ratio (OR)=1.62, 95% confidence interval (CI) (0.66, 3.94), P=0.29], superficial wound infection [OR=1.17, 95%CI (0.56, 2.47), P=0.68], pneumonia infection [OR=0.73, 95%CI (0.47, 1.13), P=0.16], or urinary tract infection [OR=1.10, 95%CI (0.65, 1.86), P=0.73] between the two groups.ConclusionWhen selecting a fixation method for hemiarthroplasty to treat eldly patients with femoral neck fracture, infection-related postoperative complications are not the determinant factor to consider.

关键词: 骨水泥; 非骨水泥; 半髋关节置换; 老年股骨颈骨折; Meta 分析

Key words: Cemented; Cementless; Hemiarthroplasty; Elderly patients with femoral neck fracture; Meta-analysis

引用本文: 刘凯, 王永才, 王红川, 蒋俊威. 骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症发生的 Meta 分析. 华西医学, 2018, 33(9): 1118-1123. doi: 10.7507/1002-0179.201802059 复制

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