Salter截骨术与Pemberton截骨术治疗儿童发育性髋关节脱位临床疗效和不良反应的Meta分析
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贵州省人民医院

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Meta analysis of the Clinical efficacy and adverse reactions of Salter osteotomy and Pemberton osteotomy in the treatment of Developmental Dysplasia of the Hip in children
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1.Guizhou Provincal People'2.'3.s Hospital,Guiyang

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    摘要:

    ]目的:对比分析Salter截骨术、Pemberton截骨术治疗儿童发育性髋关节脱位的临床疗效和安全性。方法:从pubmed、Embase、CNKI、维普和万方等数据库搜索、获得关于Salter截骨术、Pemberton截骨术治疗儿童发育性髋关节脱位的相关研究,将两种不同手术方式治疗后,患儿的髋臼指数、McKay髋关节功能评级优良率、股骨头坏死、CE角的变化情况进行meta分析,从而对比分析、分别找出两种手术方式的适应症。结果:共纳入7篇病例对照研究;共计596例患者,其中Salter截骨术组315例,Pemberton截骨术组381例;meta分析结果显示,与Pemberton截骨术相比,Salter截骨术治疗儿童发育性髋关节发育不良在McKay髋关节功能评级优良率(RR=1.04,95%CI 0.97, 1.11,P=0.31),CE角(WMD=-1.18,95%CI -4.30, 1.94,P=0.46)两方面差异统计学无意义;而在髋臼指数(WMD=-6.18,95%CI -9.66, -2.69,P=0.0005),股骨头坏死率(OR=0.34,95%CI 0.12, 0.98,P=0.05)方面差异有统计学意义。结论:分析显示,Salter截骨术与Pemberton截骨术均是治疗儿童发育性髋关节脱位的有效手术方式,但Salter截骨术在降低股骨头坏死率方面明显优于Pemterton截骨术,而Pemberton截骨术在髋臼指数改善方面明显优于Salter截骨术。

    Abstract:

    Objective:To compare and investigate the efficacy and safety of the Salter osteotomy and Pemberton osteotomy in the treatment of developing hip dislocation in children. Methods:We searched and obtained the research on Salter osteotomy and Pemberton osteotomy in the treatment of developmental dislocation of hip in children from PubMed,EMBASE,CNKI,VIP,Wanfang and the other databases,and then,analyzed the changes of the acetabulum index,the response rate, the rate of femoral head necrosis and CE by meta-analysis.Results:Seven articles involving 596 patients, including 315 patients in the Salter osteotomy group and 381 cases in the Pemberton osteotomy group;when compaired with Pemberton osteotomy group,Salter osteotomy group showed no significant difference in the response rate of treatment (RR=1.04,95%CI 0.97, 1.11,P=0.31) and CE(WMD=-1.18,95%CI -4.30, 1.94,P=0.46).There was a significant reduce in the acetabulum index(WMD=-6.18,95%CI -9.66, -2.69,P=0.0005),decrease in the rate of femoral head necrosis. Conclusion: Both of the Salter osteotomy and Pemberton osteotomy are effective methods for treating developmental dislocation of the hip in the child.However,compared with the Pemberton osteotomy,the Salter osteotomy could significantly reduce the rate of femoral head necrosis.But the Pemberton osteotomy is better than the Salter osteotomy in improving acetabular index.

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  • 收稿日期:2019-11-13
  • 最后修改日期:2019-11-15
  • 录用日期:2019-12-06
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