兰州大学机构库 >学院待认领
术前牵引与未牵引治疗髋部骨折的系统评价
Alternative TitlePreoperative traction and no traction treat hip fracture,a systematic review
岳海源
Thesis Advisor汪玉良
2010-05-21
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword牵引 髋部骨折 系统评价
Abstract【背景】随着社会人口的老龄化以及交通事故伤的逐年增加,髋部骨折已成为我国创伤骨科领域中常见且具挑战性的骨折之一[1],是老年人常见的骨折类型。由于老年人骨质疏松和全身各系统功能的老化,它已成为导致老年患者致残甚至致死的重要原因。术前牵引是髋部骨折制动的常规方法。但就术前牵引的疗效一直存在很大争议,目前尚无术前牵引治疗髋部骨折的系统评价。 【目的】评价术前牵引治疗髋部骨折的疗效和安全性。 【方法】计算机全面检索MEDLINE、EMBASE、Cochrane Library、CBM、CNKI、VIP和万方等中外文数据库上所有关于术前牵引治疗髋部骨折的随机对照试验或半随机对照试验,并辅手工检索和其他检索。按照纳入排除标准纳入文献,由两名研究者独立筛选并提取资料,采用Handbook4.2.6[2]推荐的质量评价标准评价纳入研究的质量,采用RevMan4.2.10软件[3]进行统计学处理。 【结果】最终纳入7项研究包括1000位患者。Meta分析结果显示术前牵引组与术前未牵引治疗组比较,在镇痛药物的使用情况[OR=1.28,95%CI (0.87 ,1.89) ,P=0.21],疼痛缓解分数[WMD =-0.31,95% CI (-0.90 ,0.29),P = 0.31]和复位不良率[OR=0.92,95%CI (0.34 ,2.48) ,P=0.88]上无统计学意义。 【结论】当前研究显示术前牵引并不能有效缓解髋部骨折的疼痛,对术中复位也无改善。
Other AbstractBackground With the aging population and the yearly increase in traffic injuries,hip fractures have become common in the field of orthopedic trauma and one of the challenging fractures.Since older osteoporosis and aging of the whole body system functions,hip fractures is an important reason which is leading to disability and even death in patients.Preoperative skin traction is a conventional methods of braking in the hip fractures .However,the efficacy of preoperative skin traction has been much controversy.There is no systematic review about preoperative traction treatment for the hip fractures.Objective To assess the effects of preoperative traction for the treatment of hip fracture.Methods It searched related database and identified randomized controlled trials or quasi-randomize controlled trials of preoperative traction versus no traction treatment for the hip fractures. It evaluated the quality of the included studies by handbook 4.2.6,which recommend by Cochrane Collaboration. The data analysis was conducted by using Rev Man 4.2.10. Results Seven randomized controlled trials (n=1000) were included. The Meta analysis showed that there were no significant difference between two groups in analgesic drug[OR=1.28,95%CI (0.87 ,1.89) ,P=0.21],pain relief scores[WMD =-0.31,95% CI (-0.90 ,0.29),P = 0.31] and reduction[OR=0.92,95%CI (0.34 ,2.48) ,P=0.88]. Conclusion The present study showed that there were no difference between preoperative traction and no traction in the clinical efficacy and safety. Preoperative traction have not reduced pain at the fracture site whilst the patient is waiting for surgery,and have not advantage in reduction . Further high quality and large sample randomized controlled trials should be carried out.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222690
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
岳海源. 术前牵引与未牵引治疗髋部骨折的系统评价[D]. 兰州. 兰州大学,2010.
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