经皮加压钢板与动力髋螺钉治疗老年股骨粗隆间骨折的Meta分析

A Meta-Analysis of Percutaneous Compression Plate versus Dynamic Hip Screw in the Treatment of Intertrochanteric Hip Fractures in Elderly Patients

目的比较采用经皮加压钢板(PCCP)与动力髋螺钉(DHS)治疗老年股骨粗隆间骨折的疗效。方法计算机检索Cochrane图书馆、Medline、Embase、中文期刊全文数据库、万方数据库等资源,检索PCCP与DHS治疗老年股骨粗隆间骨折的随机临床对照试验或非随机临床对照试验,在提取数据和评价纳入研究的方法学质量后,通过Meta分析比较两种方法治疗老年人股骨粗隆间骨折的疗效。结果共检索到231篇原始文献,最终纳入11篇,共1100例患者;分析结果表明PCCP相对于DHS手术时间短[WMD=-12.83,Z=2.54,P=0.01]、手术切口长度小[WMD=-7.43,Z=3.35,P<0.001]、术中出血量低[WMD=-211.41,Z=9.07,P<0.001],而且预后较好,但术后住院时间差异无统计学意义(WMD=-1.28,Z=0.89,P=0.37)。结论 PCCP更适用于老年患者股骨粗隆间骨折的治疗。

Objective To compare the efficacy of percutaneous compression plate （PCCP） and dynamic hip screw （DHS） on intertrochanteric fractures in elderly patients. Methods A literature search was performed in the Cochrane Li brary, Mdiline, EMbase, CNKI, Wanfang database and other databases. The controlled clinical trials were retrieved, which in cluded PCCP and DHS treatment for intertrochanteric fractures in elderly patients. A meta-analysis was performed to ana- lyze the efficacy of PCCP and DHS on this kind of fractures in elderly patients. Results In 231 citations initially identified, 11 eligible papers were included in this study, which consisted of a total of 1 100 patients. Results showed that there were shorter operative time （WMD=-12.83, Z=2.54, P = 0.01）, smaller incision（WMD =-7.43, Z=3.35, P 〈 0.001）, low blood loss during surgery（WMD = -211.41,2--9.07, P 〈 0.001） and better prognosis in PCCP group than those of DHS group. There was no significant difference in the length of postoperative hospital stay between PCCP and DHS group（WMD---1.28, Z= 0.89, P=0.37）. Conclusion The current analysis suggests that the PCCP is better for intertrochanteric fractures in elderly patients.