中医正骨2024，Vol.36Issue(3) ：36-41.

手法复位联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效和安全性Meta分析

Clinical outcome and safety of manipulative reduction combined with percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta-analysis

齐宏哲 郭涛 高淦
中医正骨2024，Vol.36Issue(3) ：36-41.
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  • 维普
  • 万方数据

手法复位联合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效和安全性Meta分析

Clinical outcome and safety of manipulative reduction combined with percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture:a meta-analysis

齐宏哲 1郭涛 2高淦2
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作者信息

  • 1. 贵州中医药大学,贵州 贵阳 550002
  • 2. 贵州省人民医院,贵州 贵阳 550002
  • 折叠

摘要

目的:系统评价手法复位联合经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteo-porotic vertebral compression fracture,OV CF)的疗效与安全性.方法:应用计算机检索中国知网、维普网、万方数据库、PubMed及Cochrane Library中关于手法复位联合PKP治疗OVCF的临床对照试验研究文献(观察组干预措施为手法复位联合PKP,对照组干预措施为单纯PKP).检索时限均为建库至2023年10月1日.根据文献纳入和排除标准对检索到的文献进行筛选后,对纳入文献进行质量评价,提取文献中的数据进行Meta分析.结果:共检索出文献233篇,经筛选后最终纳入文献9篇,均为中文文献.Meta分析结果显示,观察组疼痛视觉模拟量表评分低于对照组[MD=-0.67,95％CI(-1.15,-0.20),P=0.006],伤椎后凸Cobb 角改善和椎体前缘高度的恢复均优于对照组[MD=-1.54,95％CI(-2.67,-0.41),P=0.007;MD=2.81,95％CI(2.02,3.59),P=0.000],但2组在Oswestry功能障碍指数和骨水泥渗漏率方面的差异均无统计学意义[MD=-3.99,95％CI(-11.24,3.26),P=0.280;OR=0.48,95％CI(0.21,1.11),P=0.080].结论:手法复位联合PKP治疗OVCF可有效缓解患者疼痛、改善伤椎后凸畸形、恢复伤椎前缘高度,疗效优于单纯采用PKP治疗,但二者在患者日常活动能力改善及安全性方面相当.

Abstract

Objective:To systematically review the clinical outcome and safety of manipulative reduction combined with percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fracture(OVCF).Methods:All the clinical controlled trial articles about manipulative reduction combined with PKP for treatment of OVCF included from database's inception to October 1,2023 were re-trieved from the China National Knowledge Infrastructure,Vip Database,Wanfang Database,PubMed and Cochrane Library through comput-er.The patients in observation group were treated with manipulative reduction and PKP,while the ones in control group with PKP alone.The articles were screened according to the inclusion and exclusion criteria.The methodological quality of researches in the included articles was evaluated,and then a Meta-analysis was conducted.Results:Two hundred and thirty-three articles were searched out.After screening,9 Chinese articles were included in the final analysis.The results of Meta-analysis revealed that the pain visual analogue scale(VAS)score was lower,the improvement of kyphotic Cobb angle of injured vertebrae and restoration of anterior border height of vertebral body were better in observation group compared to control group(MD=-0.67,95％CI(-1.15,-0.20),P=0.006;MD=-1.54,95％CI(-2.67,-0.41),P=0.007;MD=2.81,95％CI(2.02,3.59),P=0.000);while,the comparison of Oswestry disability index(ODI)and bone ce-ment leakage incidence rate between the 2 groups revealed no significant differences(MD=-3.99,95％CI(-11.24,3.26),P=0.280;OR=0.48,95％CI(0.21,1.11),P=0.080).Conclusion:Manipulative reduction combined with PKP can effectively relieve pain,im-prove the kyphosis of injured vertebrae,and restore the anterior border height of injured vertebrae in treatment of OVCF,and its curative outcome is better than that of PKP alone;while,both are similar to each other in the improvement of activities of daily living and safety.

关键词

脊柱骨折/骨质疏松性骨折/骨折,压缩性/后凸成形术/正骨手法/专题Meta分析

Key words

spinal fractures/osteoporotic fractures/fractures,compression/kyphoplasty/bone setting manipulation/Meta-analysis as topic

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出版年

2024
中医正骨
河南省正骨研究院

中医正骨

CSTPCD
影响因子：1.912
ISSN：1001-6015
参考文献量25
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