两种常用假体在全髋置换术中应用临床效果的Meta分析

Meta-analysis of the Role of Two Common Prostheses in Total Hip Replacement

目的评价金属对金属假体和金属对聚乙烯假体在全髋置换术中应用的临床效果。方法以"金属对金属""金属对聚乙烯""全髋置换术"为关键词,在PubMed,EMBASE,Cochrane图书馆,中国知网数据库,万方数据库和维普数据库中检索国内外关于金属对金属假体和金属对聚乙烯假体在全髋置换术中应用的随机对照研究文献,筛选出符合评价标准的文献,采用RevMan 5.2软件进行Meta分析。结果在Harris功能评价方面,金属对金属组明显优于金属对聚乙烯组[WMD=4.40,95%CI(3.50,5.31),P<0.01];在手术时间方面,金属对金属组明显长于金属对聚乙烯组[WMD=6.82,95%CI(4.50,9.13),P<0.01];其他指标两组间差异没有统计学意义(P均>0.05)。结论在全髋置换术假体的选择上,金属对金属假体在功能评分上要明显占有优势,但仍需大样本、高质量的随机对照试验进一步验证。

Objective To systematically review the role of two common prostheses （ metal on metal and metal on polythene） in total hip replacement. Methods Studies on two prostheses （metal on metal and metal on polythene） in total hip replacement were searched in databases including PubMed, EMBASE, the Cochrane li- brary, CNKI database, WANFANG database, and VIP database using key words including ＂metal on metal＂, ＂metal on polythene ＂, and ＂ total hip replacement＂ . Meta-analysis was performed using RevMan 5. 2 soft- ware. Results Metal on metal group was superior to metal on polythene group in terms of Harris function evaluation （WMD=4.40, 95%CI： 3.50-5.31, P〈0.01）, operation time （WMD=6.82, 95%CI： 4.50-9.13, P〈 0. 01）, whereas other indicators showed no significant difference between these two groups. Conclusions Com- pared with the prosthesis, metal on metal is better than metal on polythene in improving the Harris function when applied for total hip replacement. However, more high-quality large-scale randomized controlled trials are required to further verify it.