骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症发生的Meta分析

Comparison of infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture: a Meta-analysis of randomized controlled studies

目的通过Meta分析比较骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症的发生情况。方法检索Cochrane图书馆、Embase、Pub Med、中国生物医学文献数据库、维普中文科技期刊数据库、中国知网、万方数据库,检索时间均为从建库至2018年1月,收集所有比较骨水泥与非骨水泥半髋关节置换治疗老年股骨颈骨折术后感染相关并发症发生情况的随机对照试验,比较两组术后伤口深部感染、浅表感染、肺部感染、尿道感染的发生情况。采用Rev Man 5.2.0软件进行Meta分析。结果共纳入11篇随机对照研究,包括1 533例患者。Meta分析结果显示:两组间术后伤口深部感染[比值比(odds ratio,OR)=1.62,95%置信区间(confidence interval,CI)(0.66,3.94),P=0.29]、浅表感染[OR=1.17,95%CI(0.56,2.47),P=0.68]、肺部感染[OR=0.73,95%CI(0.47,1.13),P=0.16]、尿道感染[OR=1.10,95%CI(0.65,1.86),P=0.73]的发生率差异均无统计学意义。结论半髋关节置换治疗老年股骨颈骨折术中是否使用骨水泥,与术后感染相关并发症的发生无关。

Objective To systematically review the postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture. Methods Cochrane Library,Pub Med, Embase, China Biology Medicine Database, Chongqing VIP China Science and Technology Journal Database,China National Knowledge Infrastructure, and Wanfang Database were searched to collect randomized controlled trials of postoperative infection-related complications between cemented and cementless hemiarthroplasty in elderly patients with femoral neck fracture from inception to January 2018. A systematic review was performed to compare the postoperative deep infection, superficial wound infection, pneumonia infection, and urinary tract infection between cemented and cementless hemiarthroplasty. Analyses were conducted using Review Manager version 5.2.0 software. Results A total of11 studies were included in the Meta-analysis, including 1 533 patients. There was no significant difference in the incidence of deep infection [odds ratio（OR）=1.62, 95% confidence interval（CI）（0.66, 3.94）, P=0.29], superficial wound infection [OR=1.17, 95%CI（0.56, 2.47）, P=0.68], pneumonia infection [OR=0.73, 95%CI（0.47, 1.13）, P=0.16], or urinary tract infection [OR=1.10, 95%CI（0.65, 1.86）, P=0.73] between the two groups. Conclusion When selecting a fixation method for hemiarthroplasty to treat eldly patients with femoral neck fracture, infection-related postoperative complications are not the determinant factor to consider.