首页|体外冲击波疗法与手术治疗骨折延迟愈合和骨不连的有效性与安全性比较:一项基于临床随机对照试验研究的Meta分析

体外冲击波疗法与手术治疗骨折延迟愈合和骨不连的有效性与安全性比较:一项基于临床随机对照试验研究的Meta分析

扫码查看
目的 采用Meta分析方法评价体外冲击波疗法(ESWT)与手术治疗骨折延迟愈合和骨不连的有效性和安全性.方法 计算机检索中国知网、万方数据库、Pubmed、Cochrane Library等中、英文数据库关于ESWT对比手术治疗骨折延迟愈合和骨不连的临床随机对照试验(RCTs),试验组采用ESWT,对照组采用手术治疗.检索时间从建库至2023年10月.结局指标包括愈合率、愈合时间、不良反应发生率、治疗费用.结果 共纳入16篇RCTs,Meta分析结果显示,对比对照组,试验组的愈合率更高(OR=1.720,95%CI:1.240~2.380,P=0.001),愈合时间(d)缩短约27 d(MD=-27.110,95%CI:-49.700~-4.510,P=0.020),治疗费用(万元)减少约3.2万元(MD=-3.200,95%CI:-3.850~-2.560,P<0.001),不良反应发生率比较差异无统计学意义(RR=0.520,95%CI:0.100~2.860,P=0.450).结论 对比手术治疗骨折延迟愈合和骨不连,ESWT愈合率更高,愈合时间更短,无严重不良反应,成本-效益优势显著,具有较好的临床应用及推广价值.
Efficacy and safety of extracorporeal shockwave therapy compared with surgery in management of delayed union and nonunion of fractures:a meta-analysis of randomized controlled trials
Objective To compare the efficacy and safety between extracorporeal shockwave therapy (ES-WT) and surgery in managing delayed union and nonunion of fractures by meta-analysis. Methods Related ran-domized controlled trials (RCTs) published until Oct. 2023 were comprehensively searched in the databases of CNKI,Wanfang,Pubmed,Cochrane Library and others. The inclusion criterion for grouping was ESWT for experi-mental group and surgery for control group. Outcome indexes included healing rate,healing time,incidence of side effects and costs. Results A total of 16 RCTs were included. The meta-analysis results showed that compared with surgery group,ESWT group revealed higher healing rate(OR=1. 720,95% CI:1. 240,2. 380,P=0. 001),shorter healing time (d,MD=-27.110,95% CI:-49.700,-4.510,P=0.020) and significantly lower costs(10,000 CNY,MD=-3.200,95% CI:-3.850,-2.560,P<0.001). Incidence of side effects showed no significant difference(RR=0.520,95% CI:0.100,2.860,P=0.450). Conclusion In the treatment of delayed union and nonunion following fractures,ESWT is superior to surgery alone,with higher healing rate,shorter healing time,no severe side effects and better cost-benefit,which is worth clinical promotion.

Bone nonunionDelayed union of fracturesExtracorporeal shockwave therapySurgeryMeta-analysis

安磊、王培建、郑妍、姜玉峰、盛炜、张丽

展开 >

中国人民解放军总医院第二医学中心康复医学科,北京 100853

国家老年疾病临床研究中心,北京 100853

中日友好医院康复医学科,北京 100029

首都医科大学附属北京天坛医院康复医学科,北京 100071

中国人民解放军总医院第一医学中心组织再生与创面修复科,北京 100853

展开 >

骨不连 骨折延迟愈合 体外冲击波疗法 手术 Meta分析

全军军事训练伤防治研究课题国家自然科学基金青年科学基金

20XLS3181801927

2024

创伤外科杂志
第三军医大学,大坪医院,野战外科研究所

创伤外科杂志

CSTPCD
影响因子:1.017
ISSN:1009-4237
年,卷(期):2024.26(5)