腰椎融合中自体髂骨植骨与骨形态发生蛋白2比较的Meta分析.docVIP

腰椎融合中自体髂骨植骨与骨形态发生蛋白2比较的Meta分析 张海飞，张治宇，崔 岩，王 锋，马承斌，张 伟(中国医科大学附属第四医院骨外科，辽宁省沈阳市 110032) 引用本文：张海飞，张治宇，崔岩，王锋，马承斌，张伟. 腰椎融合中自体髂骨植骨与骨形态发生蛋白2比较的Meta分析[J].中国组织工程研究，2016，20(43):6521-6529. DOI: 10.3969/j.issn.2095-4344.2016.43.020 ORCID: 0000-0002-2818-6404(张治宇) 文章快速阅读： 摘要 背景：骨形态发生蛋白2作为自体髂骨的替代已被广泛应用于临床及相关试验中。 目的：评估腰椎融合中骨形态发生蛋白2的有效性和安全性。 方法：检索2015年9月前中国生物医学文献数据库、Medline、Embase及Cochrane Central Register of Controlled Trial等数据库中，有关腰椎融合中骨形态发生蛋白2与自体髂骨植骨效果比较的随机对照试验，采用Cochrane系统进行Meta分析。 结果与结论：共纳入14篇随机对照试验，总共1 613例患者。Meta分析结果显示，骨形态发生蛋白2组二次手术率、手术时间少于自体髂骨植骨组(P ≤ 0.01)，融合率高于自体髂骨植骨组(P ≤ 0.01)；两组间总体疗效、并发症、术中出血量、住院时间、患者满意度及术后工作情况等比较差异均无显著性意义。基于有限的证据，相较于自体髂骨植骨，骨形态发生蛋白2治疗腰椎退行性疾病并没有显著的优越性，评估骨形态发生蛋白2应用于腰椎融合手术的有效性和安全性，需要更多高质量的并有长期随访的随机对照试验。 关键词： 生物材料；骨生物材料；骨形态发生蛋白2；腰椎融合；腰椎退行性疾病；腰痛；自体髂骨；随机对照试验；Meta分析 主题词： 骨形态发生蛋白质类；脊柱融合术；随机对照试验；组织工程 Autogeneic iliac crest graft versus bone morphogenetic protein 2 in lumbar fusion: a Meta-analysis Zhang Hai-fei, Zhang Zhi-yu, Cui Yan, Wang Feng, Ma Cheng-bin, Zhang Wei (Department of Orthopedics, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, Liaoning Province, China) Abstract BACKGROUND: As a substitute for autogeneic iliac crest, bone morphogenetic protein 2 has been widely used in lumbar fusion and relative trials. OBJECTIVE: To assess the effectiveness and safety of bone morphogenetic protein 2 in lumbar fusion. METHODS: CBM, Medline, Embase and the Cochrane Central Register of Controlled Trial databases were retrieved for relevant randomized controlled trials of bone morphogenetic protein 2 versus autogenous iliac crest graft in lumbar fusion published before September 2015. A Meta-analysis was performed utilizing the Cochrane system. RESULTS AND CONCLUSION: Totally 14 randomized controlled trials met the inclusion criteria, including 1 613 patients. Meta-analysis results showed that the reoperation rate and operation time in bone morphogenetic protein 2 group were significantly less than