微创小切口与传切口在tha中应用的系统评价.pdfVIP

摘 要 微创小切口与传统切口在THA 中应用的系统评价 研究生：武玉福 导师：杨广忠 副教授 摘 要 目的: 系统评价全髋关节置换术应用微创小切口是否优于传统切口。方法:收集 所有关于微创小切口与传统切口在全髋关节置换术中应用比较的随机对照试验 （RCT ），按Cochrane协作网标准逐个进行质量评价和Meta分析。结果:共纳入3篇RCT, 包括339例患者。3个研究显示微创小切口组在术中失血量、总失血量、手术用时方 面少于传统切口，术中、术后并发症发生率无统计学意义，而对于术后镇痛药物用 量、患肢功能恢复、术后假体影像学评价及远期手术效果由于各研究采用了不同的 评价指标，不能进行合并分析。结论:微创小切口和传统切口都可以用于全髋关节置 换术，采用微创小切口在术中失血量、总失血量、手术用时方面少于传统切口，在 术中及术后并发症方面，两种切口的差异无统计学意义。因本研究的样本量较小， 纳入的研究数量少，缺乏足够的证据，尚需更多设计严格的研究以增加证据的强度。 关键词: 全髋关节置换术；微创；传统切口；随机对照试验；系统评价 —1— 新疆医科大学医学硕士学位论文 Minimally invasive vs conventional incision for total hip arthroplasty:A systematic review Postgraduate: Wu yu-fu Advisor: Yang guang-zhong Abstract Objective:To evaluate whether using minimally invasive is better than conv- entional incision for total hip arthroplasty. Methods:All randomized controlled trials (RCTs) about comparison between minimally invasive and conventional incision for total hip arthroplasty were identified and the quality of each were evaluated by using the standard provided by Cochrane Collaboration. Some results were meta analysised. Results:Three RCTs were included. The combined results of meta-analysis showed that compared with conventional incision, minimally invasive for total hip arthroplasty can reduce the duration of operation [WMD -4.16,95%CI(-6.70,-1.61)],the amount of intra-operative blood loss[WMD -44.70,95%CI(-70.92,-18.48)]and the amount of total blood loss [WMD -85.40,95%CI(-144.00,-26.81)], but the rate of complications has no difference [OR=1.17,95%CI(0.48,2.85)]. Conclusion