气压治疗预防人工髋关节置换术后深静脉血栓的Meta分析

Meta Analysis on Efficacy of Air Pressure Therapy in Preventing Deep Venous Thrombosis for Lower Limb after Artificial Hip Replacement

目的评价气压治疗对人工髋关节术后下肢深静脉血栓(DVT)的防治作用。方法计算机检索Cochrane Library、Pubmed、Embase、中国知网(CNKI)、维普(VIP)、中国生物医学文献数据库(CBM)及万方数据库,纳入有关气压治疗防治人工髋关节术后下肢深静脉血栓的随机对照试验,根据Cochrane手册及Jadad评分标准评价纳入研究方法学质量,并应用RevMan 5.3软件统计分析。结果最终纳入5篇RCT,共572例受试者,根据Jadad标准,从随机方法、分配隐藏等方面进行评价,本研究纳入的文献质量均不高,Meta分析结果表明:与治疗相比,加用气压治疗能够降低髋关节置换术后DVT的发生率,差异有统计学意义(P<0.001);漏斗图显示各研究资料的分布基本对称,提示发表偏倚较小,Meta分析显示气压治疗能够明显降低髋关节置换术后DVT的发生率。有2篇报道了除DVT、PE之外的不良反应,所有纳入研究均无严重不良反应发生,表明气压治疗预防人工髋关节置换术后DVT的安全性良好。结论西医基础上加用气压治疗能够明显降低髋关节置换术后DVT的发生率,但受研究质量限制,其疗效及安全性需要更多高质量临床试验加以验证。

Objective To evaluate the effect of barotherapy on the prevention and treatment of lower extremity deep venous thrombosis(DVT)after artificial hip joint surgery.Methods Computer search for Cochrane Library,Pubmed,Embase,China Knowledge Network(CNKI),VIP(VIP),China Biomedical Literature Database(CBM)and Wanfang database,including the relevant pressure therapy for prevention and treatment of deep venous thrombosis of lower limbs after artificial hip joint surgery Randomized controlled trials were used to assess the quality of the included methodologies according to the Cochrane Handbook and the Jadad scoring criteria,and statistical analysis was performed using RevMan 5.3 software.Results Finally,5 RCTs were included,and a total of 572 subjects were evaluated according to Jadad criteria from random methods and allocation concealment.The quality of the literature included in this study was not high.Meta-analysis showed that compared with treatment,it was added.Air pressure therapy can reduce the incidence of DVT after hip arthroplasty,the difference was statistically significant(P<0.001);the funnel plot shows that the distribution of each study data is basically symmetrical,suggesting that publication bias is small,meta-analysis shows that barotherapy can be significantly reduced The incidence of DVT after hip replacement.Two cases reported adverse reactions other than DVT and PE.All the included studies showed no serious adverse reactions,indicating that the pressure therapy for preventing DVT after artificial hip joint replacement is safe.Conclusion The addition of barotherapy on the basis of Western medicine can significantly reduce the incidence of DVT after hip replacement.However,due to the limited quality of the study,its efficacy and safety need to be verified by more high-quality clinical trials.