PFNA与DHS对中国人群股骨粗隆间骨折疗效的Meta分析

A Meta analysis on effect of proximal femoral nail antirotation and dynamic hip screw on treatment of intertrochanteric fracture in Chinese people

目的循证分析股骨近端抗旋髓内钉(PFNA)与动力髋螺钉(DHS)治疗国人股骨粗隆间骨折的疗效。方法计算机检索万方数据库和中国知网数据库,收集关于PFNA与DHS治疗股骨粗隆间骨折的随机对照研究,依据Cochrane协作网推荐的方法对汇总数据进行Meta分析。采用随机效应和固定效应模型进行风险预测,并检测入选研究的异质性和发表偏倚。结果共纳入8篇临床随机对照研究,561例患者入选。其中,PFNA组283例,DHS组278例。与DHS组相比,PFNA组术中出血量少,手术时间、骨折愈合时间短,末次随访Harris评分优良率高(P<0.01)。结论 PFNA较DHS在治疗国人股骨粗隆间骨折上具有明显优势,可作为有条件医院进行股骨粗隆间骨折的重要手术方法。

Objective To analyze the effect of proximal femoral nail antirotation（PFNA） and dynamic hip screw（DHS） on the treatment of intertrochanteric fractures in Chinese people. Methods Wanfang and databases were systematically searched for randomized controlled trails comparing PFNA with DHS in the treatment of intertrochanteric fractures. Meta analysis was then performed according to the method provided by Cochrane Group. The risk prediction was calculated by random- and fixed- effects model, and the heterogeneity and publication bias among articles were also tested. Results Eight randomized controlled trails involving 561 patients were enrolled in this analysis, which were divided into two groups of PFNA（283 cases） and DHS（278 cases）. Compared with group DHS, the blood loss and the times for operation and fracture healing were decreased, while Harris score at the time of last follow-up was increased in group PFNA（P〈0. 01）. Conclusion Utilizing PFNA to treat intertrochanteric fractures in Chinese people achieves a better result than that of DHS, which can be considered as an effective method in the hospitals equipped well.