摘要
目的采用Meta分析法对关节镜下单排固定与双排固定治疗肩袖撕裂的疗效进行对比,为其广泛的临床应用提供循证证据。方法检索Pub Med、Springer Link、EMBASE、the Cochrane Library、Medline、Science Direct、中国知识资源总库、万方数据库、维普数据库,检索时间段为1970年1月～2014年6月,收集关节镜下单排固定与双排固定治疗肩袖撕裂疗效对比的相关文献,按纳入与排除标准筛选文献并对纳入文献进行质量评价,采用Rev Man5.2软件进行分析。结果共纳入13篇文献,病例数合计为840例,其中关节镜下单排固定组427例,双排固定组413例。结果显示在主要观察指标中,关节镜下单排固定术后肩袖再撕裂的风险高于双排固定组（OR=2.31,95%CI：[1.57,3.39],P〈0.001）,单排固定组术后ASES（the American shoulder and elbow surgeons scores）评分（MD=-0.85,95%CI：[-1.66,-0.03],P=0.04）及术后UCLA（the University of California,Los Angeles score）评分（MD=-0.85,95%CI：[-1.27,-0.20],P=0.007）分别低于双排固定组术后评分,而术后Constant评分及WORC评分两组间差异无统计学意义;在次要观察指标分析中,双排固定组在前屈活动度、肩关节外展、肩关节内旋方面优于单排固定组（P〈0.05）,在术后患者满意度、外旋活动度、肩关节外旋等指标两组之间无统计学意义（P〉0.05）。结论关节镜下双排固定治疗肩袖撕裂,术后发生肩袖再次撕裂的风险低于单排固定,在术后ASES评分、UCLA评分、前屈活动度、肩关节外展、肩关节内旋等方面优于单排固定,尚无证据表明两组在Constant评分、WORC评分、术后患者满意度、内旋活动度、外旋活动度、肩关节外旋方面有明显差异。
Objective To evaluate the effects of arthroscopic single -row versus double -row fixation in treating rotator cuff tear, so as to provide evidence - based information for its clinical application. Methods Eligible studies were identified from electronic databases including PubMed, SpringerLink, EMBASE, the Cochrane Library, Medline, Science Direct, CNKI, WanFang data and VIE data. The retrieved literature was selected according to the inclusion and exclusion criteria and a meta analysis was performed with the software RevMan 5.2 after identification of the relevant data. Results Thirteen studies met our inclusion criteria, including 427 cases in the single -row fixa- tion group and 413 cases in the double - row fixation group. The re - tear risk of the single row fixation group was higher than that of the double -row fixation group（ P 〈 0.001 ）. The ASES score （the American shoulder and elbow surgeons scores） and UCLA score （the University of California, Los Angeles score）in the single -row fixation group were lower than those of the double - row fixation group, but the Constant score and WORC score （ the Western Ontar- io rotator cuff index score） were found to have no statistical difference. The forward flexion motion, shoulder external rotation and shoulder internal rotation were better in the double - row fixation group than those of the single - row fixa- tion group（P 〈0.05）, while there was no statistical difference in indicators such as patients＇ satisfaction, internal ro- tation motion, external rotation motion and shoulder internal rotation （ P 〉 0.05. Conclusion Double - row fixation for treating rotator cuff tear has lower risk of re - tear and can obtain better results in the ASES score, UCLA score, shoulder abductor motion and shoulder internal rotation. However, there is no detectable difference in the Constant score,WORC score, satisfaction, internal rotation motion, external rotation motion and shoulder external rotation be-tween single -row and double -row fixations.
出处
《创伤外科杂志》
2016年第1期32-38,共7页
Journal of Traumatic Surgery
关键词
肩袖撕裂
关节镜
固定
META分析
rotator cuff tear
arthroscopy
fixation
meta analysis
