Bernese髋臼周围截骨术并发症的Meta分析

Systematic evaluation and meta-analysis of complications of Bernese periacetabular osteotomy

目的用Meta分析技术,对已发表的相关文献进行分析,总结Bernese髋臼周围截骨术(bernese periacetabular osteotomy,PAO)并发症的种类及发生率。方法以"Bernese periacetabular osteotomy"或"Ganzeperiacetabular osteotomy"或"PAO"或"complication"或"Morbidity"词,检索Pub Med Medline、Ovid Medline、Cochrane Database、Embase Database等数据库,检索2001年1月至2015年12月的所有文献,共检索到174篇文献。根据检索条件及评价标准,最终筛选出16篇文献,共计2528例。采用SPSS 13.0及其Meta程序包对检索结果进行统计分析。结果 PAO主要并发症包括术区感染[I^2=0.0%,95%CI:0.00~0.03(P<0.01)]、骨折不愈合[I^2=0.0%,95%CI:0.007~0.028(P<0.01)]、皮下血肿或血清肿[I^2=0.0%,95%CI:0.015~0.045(P=0.000)]、神经损伤[I^2=0.0%,95%CI:0.015~0.045(P=0.000)]、感觉障碍[I^2=4.5%,95%CI:0.013~0.038(P=0.000)]。结论 PAO是并发症发生率较低,术区感染、皮下血肿和血清肿、骨折不愈合、神经损伤、感觉障碍是较常见的并发症,术者在围手术期应积极预防和注意。

Objective By using a meta analysis in evidence-based medicine, to summarize the types and occurrence rate of complications in Bernese periacetabular osteotomy（ PAO） based on the published literature. Methods After searching at Pub Med, Ovid Medline, Cochrane Database, Embase Database and other databases, 16 clinical trials were identified to meet the inclusion criteria, totally 2528 patients were included. SPSS 13.0 and its Meta program were used to calculate. Results The main complications of PAO were infection of incision wound [ I-2 = 0.0%, 95% CI： 0.00- 0.03（ P〈0.01） ]; nonunion [ I-2 = 0.0%, 95% CI： 0.007- 0.028（ P〈0.01） ]; hematomas or seroma [ I-2 = 0.0%, 95% CI： 0.015- 0.045（ P = 0.000） ]; nerve injuries [ I-2 = 0.0%, 95% CI： 0.015- 0.045（ P = 0.000） ]; dysfunction of sensation [ I-2 = 4.5%, 95% CI： 0.013- 0.038（ P = 0.000） ]. Conclusions The Bernese periacetabular osteotomy has a low rate of complications, like infection of incision wound, subcutaneous hematoma or seroma, nonunion, nerve injury, sensory dysfunction. Surgeons should actively prevent and pay attention to it in the peri-operative period.