改良Stoppa入路与髂腹股沟入路治疗骨盆、髋臼骨折的Meta分析

摘要

背景:骨盆、髋臼骨折常用的手术治疗方式包括髂腹股沟入路及改良Stoppa入路,选择何种入路更为安全有效仍存在争议,需要循证医学证据来评价不同入路方式的优缺点.目的:比较改良Stoppa入路与髂腹股沟入路治疗骨盆、髋臼骨折的临床疗效.方法:计算机检索Cochrane library、PubMed、Embase、OVID、中国期刊网全文数据库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)及维普中数据库(VIP)建库至2016年10月间,有关改良Stoppa入路与髂腹股沟入路治疗骨盆、髋臼骨折的随机对照试验.采用RevMan 5.3软件对纳入文献进行合成分析.结果与结论:①最终纳入了11篇随机对照试验,总共722例患者;②最终Meta分析的结果示:改良Stoppa入路组手术时间、术中出血量、手术切口长度、伤口引流量、住院时间均小于或少于髂腹股沟入路组(P<0.05),且临床疗效显著(P<0.05);2组在术后并发症、Matta评分方面差异无显著统计学意义(P>0.05);③由此可见,改良Stoppa入路是治疗骨盆、髋臼骨折更为安全有效的方法.%BACKGROUND: Ilioinguinal approach and modified Stoppa approach are commonly used to treat pelvic and acetabular fractures, but which one is safer and more effective remains controversial, so a meta-analysis is necessary.OBJECTIVE: To compare the efficacy of modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures.METHODS: A computer-based retrieval of Cochrane library, PubMed, Embase, OVID, CNKI, WanFang, CBM and VIP databases was performed for the randomized controlled trials concerning modified Stoppa approach and ilioinguinal approach for pelvic and/or acetabular fractures published before October 2016. Meta-analysis was performed on RevMan5.3 software.RESULTS AND CONCLUSION: (1) Finally 11 randomized controlled trials were enrolled, including 722 patients. (2) Meta-analysis showed that the operation time, intraoperative blood loss, length of incision, volume of drainage and hospitalization time in the modified Stoppa approach group were significantly less than those in the ilioinguinal approach group (P < 0.05), and the clinical efficacy in the modified Stoppa approach group was significantly superior to that in the ilioinguinal approach group (P < 0.05). But there were no significant differences in Matta scores and postoperative complications between two groups (P > 0.05). (3) To conclude, modified Stoppa approach is safer and more effective for pelvic and/or acetabular fractures.