选择性脊神经后根切断术治疗脑性瘫痪儿童的荟萃分析
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北京中医药大学东直门医院

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Selective posterior rhizotomy improves in children with cerebral palsy: a meta-analysis
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Dongzhimen Hospital, Beijing University of traditional Chinese medicine

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    摘要:

    [目的] 以meta分析评估SPR改善脑性瘫痪儿童下肢步态、关节运动等方面的疗效。[方法] 文献检索在PubMed、Embase、Web of Science、Cochrane图书馆、CBM、CNKI、万方、VIP电子数据库中进行。纳入有关SPR治疗脑性瘫痪的对照研究进行meta分析,至少2名研究员独立筛选文献、提取数据和评估,使用Cochrane 5.1.0偏倚风险评估工具对纳入的RCTs质量进行评估,使用MINORS评估nRCTs的方法学质量,数据分析采用Revman 5.3软件。[结果] 共检索到4115篇文献,其中英文1829篇,中文2284篇;经过筛选后7项研究纳入meta分析,均为英文文献,共计219例脑瘫患者,其中SPR组112例,非SPR组107例。合并结果显示SPR对脑瘫患者步态分析(步长)、关节运动(膝关节伸展、踝关节背伸、踝关节跖屈、足前进角)等方面的改善优于非SPR组(P<0.05)。对于步态分析中的步频、步速,关节运动中的髋关节屈/伸、髋关节伸展、膝关节屈/伸、屈膝摆动,以及骨盆倾斜角和骨盆旋转角,SPR组与非SPR组没有明显统计学差异(P>0.05)。[结论] SPR能够改善CP儿童步态质量,以及膝关节、踝关节的运动学参数,SPR对下肢远端关节的改善更明显。

    Abstract:

    [Objective] Meta analysis was used to evaluate the effect of SPR on lower limb gait and joint kinematics in children with cerebral palsy. [Methods] Literature search was conducted in PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, Wanfang and VIP databases. At least two reviewers independently extracted data. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of RCTs. MINORS was used to evaluate the methodological quality of nRCTs. Revman 5.3 software was used for data analysis. [Results] A total of 4115 literature were retrieved, including 1829 English literature and 2284 Chinese literature. After the screening, 7 were included in Meta analysis, all of which were English literature. A total of 219 patients with cerebral palsy were included in the meta-analysis, including 112 patients in SPR group and 107 patients in nSPR group. The results showed that SPR was better than the nSPR group in gait analysis (stride length), joint movement (knee extension, ankle back extension, ankle plantar flexion and foot forward angle) (P<0.05). There was no significant difference in gait frequency, gait speed, hip flexion/extension, hip extension, knee flexion/extension, knee flexion and swing, pelvic tilt angle and pelvic rotation angle between SPR group and nSPR group (P>0.05). [Conclusion] SPR can improve the gait quality of CP children, as well as the kinematic parameters of knee joint and ankle joint, and the improvement of distal joint is more obvious.

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  • 收稿日期:2021-06-16
  • 最后修改日期:2021-09-11
  • 录用日期:2021-11-05
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