目的 评价早期预防脑瘫患儿继发髋关节发育不良疗法的有效性.方法 检索CNKI、万方、VIP、CBM、PubMed、Embase、Web of Science和Cochrane Library数据库,收集从建库至2022年4月发表的有关预防脑瘫髋关节发育异常疗法的RCT.由两位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 16.0软件和ADDIS 1.16.8软件进行贝叶斯网状Meta分析.结果 最终纳入21个RCT,共包括1228例脑瘫患儿.网状Meta分析表明:(1)常规康复治疗联合家庭髋关节姿势管理、肌肉电刺激、穴位埋线、WBV,分别在改善MP值、内收肌肌张力、GMFM-E区评分、髋关节ROM评价方面疗效最佳;(2)在改善胭绳肌肌张力的评价中,常规康复治疗+靳三针头针+体针治疗效果明显优于常规康复治疗.结论 家庭髋关节姿势管理在改善MP值方面临床前景最好,针灸联合常规康复治疗在改善肌张力方面疗效明确.
Effects of Different Interventions on Hip Dysplasia Secondary to Cerebral Palsy in Children:A Network Meta-analysis
Objective To evaluate the efficacy of different interventions in the prevention of hip dysplasia second-ary to cerebral palsy in children.Methods The randomized controlled trials(RCTs)about the interventions in hip dyspla-sia secondary to cerebral palsy were retrieved from China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP,China Biology Medicine(CBM),PubMed,Embase,Web of Science,and Cochrane Library with the time interval from in-ception to April 2022.Two evaluators independently screened the articles,extracted the data,and evaluated the bias risk of the studies included.Stata 16.0 and ADDIS 1.16.8 were used for Bayesian network meta-analysis.Results A total of 21 RCTs involving 1 228 children with cerebral palsy were included.The network meta-analysis revealed the following re-sults.(1)Conventional rehabilitation therapy combined with home-based hip joint posture management,electrical muscle stimulation,catgut embedment in acupoint,and whole-body vibration(WBV)showed the best efficacy in improving the muscle potential(MP),muscle tension of adductor,gross motor function measure-expanded(GMFM-E)score,and range of motion(ROM)of hip joint,respectively.(2)In terms of improving hamstring muscle tension,conventional rehabilitation therapy+Jin's acupuncture at three acupoints on the head+body acupuncture outperformed conventional rehabilitation therapy.Conclusion Home-based hip joint posture management has the best clinical prospect in improving the MP,and acupuncture combined with conventional rehabilitation therapy demonstrates definite efficacy in improving muscle tension.
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万方数据
