一期双侧全膝关节置换引流与否疗效比较的Meta分析

A Meta-analysis of complications of total knee arthroplasty with or without drainage

目的 应用Meta分析系统总结评价一期双侧全膝关节置换（TKA）引流和不引流的临床疗效与安全性.方法 计算机检索PubMed、Embase、Cochrane图书馆、CNKI、万方数据库,并手工补充检索重要参考文献所附的参考文献,纳入2014年3月之前一期双侧TKA引流与不引流的临床随机对照试验.根据PEDro量表评价纳入研究质量,并采用RevMan 5.0软件进行Meta分析.结果 共纳入3项随机对照研究,共计125例患者,平均年龄65岁（37 ～ 84岁）,患者的平均随访时间为14个月（12 ～ 28个月）.结果显示,一期双侧TKA引流组和不引流组并发症发生例数分别为17例和56例.在皮肤瘀斑方面,TKA引流组低于不引流组（P＜0.01）.在伤口愈合、伤口感染、水肿、深静脉血栓方面,TKA引流组与不引流组之间差异无统计学意义（P＞0.05）.结论 一期双侧TKA术后引流与不引流具有相似的临床疗效与安全性.

Objective To compare the complication rate of one stage total knee arthroplasty （TKA） with or without drainage.Methods Studies published up to March 2014 were searched in the databases of PubMed,Embase,Cochrane Library,CNKI and Wan Fang databases,supplemented with manual searching of relevant references of key studies,using the searching terms ＂drainage＂,＂one-stage＂,＂total knee arthroplasty＂ and ＂randomized controlled trials＂.The methodological quality of included studies was evaluated by Physiotherapy Evidence Database scale.The analyses were performed with Cochrane RevMan software version 5.0.Results A total of three randomized controlled trials reporting on 125 patients with an average follow-up of 14 months met the predetermined inclusion criteria.There were 56 total complications in TKA without drainage and 17 with drainage,P ＜ 0.01.Except less erythema and ecchymosis around the wound in drainage group,there were no statistical differences in wound healing,wound infection,swelling and deep vein thrombosis in one-stage bilateral TKA with and without drainage （P ＞ 0.05）.Conclusion Both drainage and non-drainage have similar clinical value in one-stage bilateral TKA.However,the conclusion should be used with caution due to the limitations of the current study.