人工髋关节置换术主要不良事件发生率的Meta分析

Incidence of Main Adverse Events of Hip Arthroplasty: A Meta-analysis

目的：了解国内外人工髋关节不良事件的发生情况。方法：2015年5月利用人工髋关节、不良事件、安全性等检索词检索中国生物医学文献数据库（Sinomed）、中国期刊全文数据库（CNKI）、中文科技期刊全文数据库（VIP）、万方数据库、Pub Med、EMBASE、Clinical Trials.gov、Cochrane Library等多个数据库。对于符合纳入标准的文献,提取基本信息、方法学特征、干预特征和不良事件发生情况等信息,采用率的Meta分析的随机效应或固定效应模型对各个不良事件发生率进行加权合并。结果：纳入分析的文献共514篇,关注的不良事件主要为假体断裂、脱位、松动、骨水泥中毒、不能排除假体因素的感染、不明原因假体周围骨折等6种,其他不良事件包括疼痛、假体发生声响、异位骨化、假体瘤形成等。总的不良事件发生率合计为5.4%（95%CI：4.7%~6.2%）,其中六种主要不良事件总体发生率合计为4.5%（95%CI：4.0%~5.2%）。单个不良事件报告最多的是松动,发生率为3.1%（95%CI：2.3%~4.2%）,其次为感染、脱位、不明原因骨折。结论：人工髋关节置换术不良事件发生率较高,应重视对其不良事件的防治。

Objective： To understand the occurrence of adverse events of the artificial hip joint at home and abroad. Methods： The Chinese biomedical literature database（ CBMDisc）,China Academic Journals Full-text Database（ CNKI）,China science and technology journal database（ VIP）,Wan Fang database,Pub Med,Clinical Trials. gov,EMBASE,Library Cochrane and other databases were searched using ＂artificial hip joint and（ adverse events or safety） ＂as keywords in May 2015. For literatures meet the inclusion criteria,the basic information,methodology characteristics,intervention characteristics,adverse events and other information were extracted. The incidence of adverse events of each study was merged using the random effect model of rate meta analysisn. Results： A total of 514 articles were included in the analysis. The main concerned seven adverse events were prosthesis cracking,dislocation,loosening,bone cement poisoning,infection can＇t exclude reasons of the prosthesis,and periprosthetic fracture for unknown cause. Other adverse events include pain,prosthesis noise,heterotopic ossification,pseudotumors formation and so on. The overall incidence of all the adverse events was 5. 4%（ 95% CI： 4. 7%-6. 2%）,and the overall incidence of the top six adverse events was 4. 5%（ 95% CI：4. 0%-5. 2%）. The adverse event reported most was loosening,whose total incidence was 3. 1%（ 95% CI： 2. 3%-4. 2%）,followed by infection,dislocation,unknown cause fractures. Conclusion： The incidence of hip arthroplasty adverse events was high,so we should pay more attention to the prevention and treatment of those adverse events.