保护锁骨上神经治疗锁骨骨折的Meta分析更新
Meta-Analysis Update of Supraclavicular Nerve Protection for Clavicular Fractures
李湛川 1王冰怡 1勉昱琛 1张博志 1魏松英2
作者信息
- 1. 宁夏医科大学,宁夏 银川 750004
- 2. 宁夏回族自治区人民医院创伤骨科,宁夏 银川 750002
- 折叠
摘要
目的:探讨切开复位内固定术中保护锁骨上神经治疗锁骨骨折的临床疗效.方法:在中英文电子数据库(包括中国知网数据库、万方数据库、维普数据库、EMBASE、Cochrane library、CBM、Web of Science以及PubMed等)中进行相关文献的检索,包括随机对照试验(RCT)和非随机干预性研究(NRSI).筛选文献、提取数据并采用相关量表对纳入文献质量进行评价,采用RevMan5.4、Stata 14.0软件进行Meta分析评估术中保护锁骨上神经对锁骨骨折患者的影响.结果:共纳入 22 篇,1 537 例锁骨骨折患者,RCT研究 10 篇,NRSI研究 12 篇,Meta分析结果得出SN损伤比例(OR=0.01,95%CI=0.01～0.06);麻木面积(MD=-17.14,95%CI=-23.87～-10.40);VAS评分(MD=-1.29,95%CI=-1.97～-0.62);麻木对生活的影响(OR=0.18,95%CI=0.05～0.65)均低于对照组,组间差异有统计学意义(P<0.05).Constant-Murley评分(MD=13.03,95%CI=11.72～14.33);手术优良率(OR=7.44,95%CI=3.03～18.26,P);术后无麻木比例(OR=7.35,95%CI=3.31～16.33)均低于对照组,组间差异有统计学意义(P<0.05).结论:对锁骨骨折的病人手术中采用切开复位内固定术保护锁骨上神经,这样可以显著地降低SN损伤病例数,同时还可以显著地缓解术后患肢的疼痛,明显减少肩部区域的麻木范围,促进患者术后患肢功能的有效恢复,提高患者术后的生活质量,具有安全的疗效,值得临床推广.
Abstract
Objective:To investigate the clinical effect of protecting supraclavicular nerve in the treatment of clavicular fracture during open reduction and internal fixation.Methods:Search relevant literature in Chinese and English electronic databases(including CNKI database、Wanfang database、VIP database、EMBASE、Cochrane library、CBM、Web of Science and PubMed,etc).They include randomized controlled trials(RCTS)and non-randomized intervention studies(NRSI).Literature was screened,data were extracted,and the quality of the included literature was evaluated using relevant scales.Meta-analysis was performed using RevMan5.4 and Stata 14.0 software to evaluate the effect of intraoperative supraclavicular nerve protection on patients with clavicular fracture.Results:A total of 22 studies were included,including 1 537 patients with clavicle fracture,including 10 RCT studies and 12 NRSI studies.The results of meta-analysis showed the SN injury ratio(OR=0.01,95%CI=0.01～0.06).Numbness area(MD=-17.14,95%CI=-23.87-10.40);VAS score(MD=-1.29,95%CI=-1.9～-0.62);The impact of numbness on life(OR=0.18,95%CI=0.05-0.65)was lower than that of control group,and the difference was statistically significant(P<0.05).Constant-Murley score(MD=13.03,95%CI=11.72-14.33);The good and good rate of operation(OR=7.44,95%CI=3.03-18.26);The proportion of postoperative numbness free(OR=7.35,95%CI=3.31-16.33)was lower than that of control group,and the difference was statistically significant(P<0.05).Conclusion:The use of open reduction and internal fixation to protect the supraclavicular nerve in the operation of patients with clavicular fractures can significantly reduce the number of SN injury cases,significantly relieve the postoperative pain of the affected limb,significantly reduce the numbness range of the shoulder region,promote the effective recovery of the function of the affected limb after the operation,improve the postoperative quality of life of the patients,and have a safe effect.It is worthy of clinical promotion.
关键词
锁骨骨折/切开复位内固定术/保护锁骨上神经/Meta分析Key words
Clavicle fracture/Open reduction and internal fixation/Protect supraclavicular nerve/Meta-analysis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据