Objective To collect domestic and foreign literatures on mini-invasive total hiparthroplasty (THA) and conventional THA so as to assay the clinical outcomes of the two treatments usingMeta analysis.Methods Randomized controlled trials (RCTs) of mini-invasive THA and conventionalTHA that met the inclusion criteria were collected in the computer-based retrieval combined with manualretrieval of databases such as MEDLINE,EMBASE,OVID,and ScienceDirect.Methodological qualityassessment of the included literatures was performed using Cochrane risk evaluation tool and Meta analysisof those literatures was made by employing RevMan 5.1 software.Two surgical approaches were comparedin regard of indices including postoperative Harris hip score,operation time,intraoperative blood loss andcomplications.Results The study involved 17 related articles (18 RCTs containing 1 560 patients),including 774 patients treated by mini-invasive THA and 786 by conventional THA.The study showedsignificant differences between mini-invasive THA and conventional THA in aspects of incision length[WMD=-5.93,95％ CI (-7.29,-4.57)],blood loss [SMD =-0.45,95％ CI (-0.77,-0.13)] and postoperative visual analog scale (VAS) [MD =-19.58,95％ CI (-26.38,-12.78)],whereas there were no significant differences regarding the postoperative Harris score [WMD =0.85,95％ CI (-3.50,5.20)],operation time [WMD=-0.99,95％ CI (-5.36,3.39)],blood transfusion volume [WMD =-66.29,95％ CI (-241.31,108.72)] and complication incidence rate [RR =1.01,95％ CI (0.61,1.66)].Conclusions Mini-invasive THA offers advantages of smaller incision,less intraoperative blood loss and milder postoperative pain over conventional THA but has similar effect with conventional THA in aspects of Harris hip score,operation duration,blood transfusion volume and complications.Moreover,high quality,multicenter and large scale RCTs are required to confirm the outcomes.%目的 通过检索和分析国内外相关文献,应用Meta分析的方法评价微创和传统人工全髋关节置换术(total hip arthroplasty,THA)的临床疗效. 方法 计算机检索MEDLINE、EMBASE、OVID、ScienceDirect等数据库并结合手工检索,按照既定的纳入和排除标准查找有关微创THA与传统THA的临床随机对照试验(randomized controlled trials,RCTs).使用Cochrane风险评估工具对纳入的文献进行方法学质量评价,并使用RevMan 5.1软件进行Meta分析.比较两种手术方式术后Harris评分、手术时间、出血量、并发症等结局指标. 结果 最终纳入17篇文献,共18项RCTs,1 560例患者进行评价,其中微创THA 774例,传统THA 786例.研究结果显示,微创THA与传统THA在切口长度[WMD=-5.93,95％ CI(-7.29,-4.57)]、出血量[SMD=-0.45,95％ CI(-0.77,-0.13)]和术后疼痛视觉评分(visual analog scale,VAS)[MD=-19.58,95％ CI(-26.38,-12.78)]方面的差异均有统计学意义.而在术后Harris评分[WMD=0.85,95％ CI(-3.50,5.20)]、手术时间[WMD=-0.99,95％ CI(-5.36,3.39)]、输血量[WMD=-66.29,95％ CI(-241.31,108.72)]、并发症发生率[RR=1.01,95％ CI(0.61,1.66)]方面的差异均无统计学意义. 结论 尽管微创THA较传统THA的切口小、出血量少、术后疼痛轻,但术后功能的恢复、手术时间、输血量和并发症的发生率与传统THA相当.需进一步开展高质量、多中心、大样本的RCTs去验证.
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