文献类型：期刊文献

中文题名：经皮椎体后凸成形术与保守治疗骨质疏松性椎体压缩骨折的荟萃分析

英文题名：Percutaneous kyphoplasty versus conservative treatment for osteoporotic vertebral compression fracture: a meta-analysis

作者：王志鹏[1];张晓刚[1];李元贞[1];张宏伟[1];赵希云[1];曹盼举[2];蒋宜伟[1,2]

第一作者：王志鹏

机构：[1]甘肃中医药大学附属医院骨科,兰州730020;[2]甘肃中医药大学,兰州730000

第一机构：甘肃中医药大学第二附属医院

年份：2019

卷号：27

期号：4

起止页码：336

中文期刊名：中国矫形外科杂志

外文期刊名：Orthopedic Journal of China

收录：CSTPCD;;北大核心:【北大核心2017】；CSCD:【CSCD_E2019_2020】；

基金：甘肃省中医药管理局支撑项目(编号:GZK-2017-17)

语种：中文

中文关键词：经皮椎体后凸成形术;保守治疗;骨质疏松;椎体压缩骨折;荟萃分析

外文关键词：percutaneous kyphoplasty;conservative treatment;osteoporotic vertebral;compression fracture;meta-analysis

摘要：[目的]系统评价经皮椎体后凸成形术(PKP)与保守方法治疗骨质疏松性椎体压缩骨折(OVCF)的有效性和安全性。[方法]计算机检索CNKI、CBM、WanFang Data、VIP、PubMed、The Cochrane Library以及EMbase数据库,搜集关于PKP对比保守方法治疗OVCF的随机对照试验,检索时限均从建库至2017年7月。由两位评价员独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行荟萃分析。[结果]最终纳入9个RCT研究,共计1 156例患者,PVP治疗548例,保守治疗608例。短-中期随访PKP组在VAS评分、椎体后凸畸形、生活质量评分方面优于保守组,差异有统计学意义(P<0.05)。但长期随访两组VAS评分、椎体再骨折率、并发症发生率差异无统计学意义(P>0.05)。此外,PKP组在椎体高度、椎体高度丢失率和椎体后凸畸形角方面明显优于保守组,差异有统计学意义(P<0.05)。[结论]现有证据表明,PKP手术治疗OVCF短、中期疗效优于保留治疗,两种治疗方式在安全性方面无显著差异。受纳入研究质量和随访时间的限制,未来还需更多远期随访的大样本、高质量的RCT研究来进一步验证。
[Objective] To compare the efficacy and safety of percutaneous kyphoplasty(PKP) versus conservative treatment for osteoporotic vertebral compression fracture(OVCF) by a meta-analysis. [Methods] The CNKI, CBM, WanFang Data,VIP, PubMed, Cochrane Library, and EMbase database were searched for random control trials(RCT) on PKP versus conservative treatment for OVCF from the beginning to July 2017. The identified articles were screened and assessed for inclusion into this study by two independent reviewers. After that, a meta-analysis was carried out by using RevMan 5.3 software. [Results] A total of 9 RCT were included with a total of 1 156 patients, involving 548 patients treated by PKP and 608 patients treated conservatively. Regarding to short and medium term follow-up, the PKP group was significantly superior to the conservative group in the VAS scores, quality of life and kyphosis correction, which proved statistically significant(P<0.05). However, there were no statistically significant differences in VAS score, vertebral refracture rate and complication in long term follow-up between the two groups(P>0.05). In addition, the PKP group proved significantly superior to the conservative treatment in vertebral height restoration, loss of vertebral height correction and extent of kyphosis, which were statistically significant(P<0.05). [Conclusion] Compared with conservative treatment, PKP achieve improved short and medium outcomes for OVCF, although no significant difference in safety between the two treatments is evident. Limited by the quality and follow-up time of the studies included, more large samples and high-quality RCT studies with longer term follow-up are needed in the future to verify the conclusions further.