冲击波对骨折愈合的影响

摘要

OBJECTIVE: To retrospect the animal experiments of shockwave and fracture healing as well as the research results of clinical application in order to make sure whether shockwave is an ideal treatment method for unhealing fracture.DATA SOURCES: Computerized search through Medline about the articles regarding the effects of shockwave on fracture unhealing during January 1964 to April 2004 was conducted. The key words were shockwave, fracture healing and the language was restricted in English. Meanwhile, same search was conducted to the correlated articles during January 1998 to April 2004 from magazine Zhongguo Linchuang Kangfu Zazhi with the key words of Chinese terms of shockwave and fracture healing.STUDY SELECTION: Totally 39 original research reports about effects of shockwave on fracture healing from home and abroad were selected. Non-randomized research literatures were excluded while non-blind ones were included.DATA EXTRACTION: Totally 25 out of 32 articles related to effects of shockwave on fracture healing were met with the criteria. The 7 articles were excluded due to the repeated same research. The rest 25 were sorted and organized and conducted literature review.DATA SYNTHESIS: Animal experiments indicate that shockwave can be sheltered and absorbed by bone tissue therefore stimulate the proliferation of osteoblasts and formation of bone callus to accelerate the fracture healing. The clinical application also suggests that the successful rate of shockwave therapy to fracture unhealing is about 70% - 90% and it was advised that it was an ideal treatment for delayed healing or unhealing of fracture as a safe and non-invasive method.CONCLUSION: More and more evidences have proved that shockwave can stimulate the healing of fracture. Before comparing its effects with other methods treating delayed healing and unhealing of fracture, multiple centered, randomly and double blind experimental research of extracorporeal shockwave therapy are needed.%目的:回顾冲击波与骨折愈合的动物实验和临床应用研究结果,明确冲击波能否成为治疗骨折不愈合的较为理想治疗方法.资料来源:应用计算机检索Medline 1964-01/2004-04关于冲击波影响骨折不愈合研究方面的相关文章,检索词"Shock Wave,Fracture Healing",并限定文章语言种类为English.同时应用计算机检索<中国临床康复>杂志1998-01/2004-04期间的上述相关文章,限定文章语言种类为中文,检索词"冲击波、骨愈合".资料选择:选择有关冲击波影响骨折愈合的中外研究原著性文献39篇,排除非随机研究原著性文献,未排除非盲法研究原著的文献.数据提炼:32篇关于冲击波影响骨折愈合的文献,25篇符合标准.排除的7篇文献因是重复的同一研究,对剩余25篇关于冲击波影响骨折愈合的文献进行分类整理,予以综述.资料综合:动物实验研究提示冲击波可被骨组织遮挡和吸收,促进骨母细胞增生和骨痂形成,加速骨折愈合;临床应用研究提示冲击波治疗骨折不愈合的成功率为70%～90%,作为非侵入性治疗,安全有效,应成为治疗骨折延迟愈合和不愈合的首选疗法.结论:越来越多的证据表明冲击波可以促进骨折愈合.在与其他治疗骨折不愈合和延迟愈合的方法进行治疗效果比较之前尚需要进行体外冲击波治疗骨折延迟愈合和不愈合的多中心、随机、双盲试验研究.