Department of Orthopaedics, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, No,2800 Gongwei Road, Huinan Town, Pudong, Shanghai 201399, China.
Eur J Med Res. 2013 Dec 10;18(1):55. doi: 10.1186/2047-783X-18-55.
In our study, we used meta-analysis to study the efficacy of the tourniquet on ankle trauma surgery. Postoperative infection rate, deep venous thrombosis incidence, hospital stay, and joint range of motion were studied to compare the tourniquet and non-tourniquet groups and provide certain references for clinical decision.
We searched PubMed, MEDLINE, EMBASE, and the Cochrane controlled trials register for all publications about the efficacy of tourniquet published before November 2012. The quality of included studies was evaluated by two estimators. I2-test and Q-statistic were used for heterogeneity analysis. When there was heterogeneity between studies, the random effects model analysis was applied or else the fixed effects model analysis was used.
Three studies were included with 166 patients suffering from ankle trauma surgery. There was no statistical difference (P >0.05) between the tourniquet and non-tourniquet groups on operation time (mean difference (MD) -5.45, 95% confidence intervals (CI): (-13.98, 3.09)), postoperative infection rate (relative risk (RR) 1.83, 95% CI: (0.65, 5.12)), and deep venous thrombosis incidence (RR 4.13, 95% CI: (0.47, 36.17)). But statistical significances were observed on hospital stays (MD 3.17, 95% CI: (1.39, 4.95)) and joint range of motion (MD - 5.25, 95% CI: (-9.61, -0.89)).
In general, the efficacy of the tourniquet group is comparable to that of the non-tourniquet group. The non-tourniquet group achieved greater benefits for the joint range of motion and reduced the hospital stay. However, a larger number of primary studies is still required for future evaluation of tourniquet efficacy on ankle trauma surgery.
在我们的研究中，我们使用荟萃分析来研究止血带在踝关节创伤手术中的疗效。研究了术后感染率、深静脉血栓形成发生率、住院时间和关节活动范围，以比较止血带组和非止血带组，并为临床决策提供一定的参考。
我们检索了 PubMed、MEDLINE、EMBASE 和 Cochrane 对照试验登记处，以获取截至 2012 年 11 月发表的所有关于止血带疗效的出版物。使用两名评估员评估纳入研究的质量。I 2 检验和 Q 统计量用于异质性分析。当研究之间存在异质性时，应用随机效应模型分析，否则应用固定效应模型分析。
纳入了 3 项研究，共 166 例踝关节创伤手术患者。在手术时间（均数差值（MD）-5.45，95%置信区间（CI）：（-13.98，3.09））、术后感染率（相对危险度（RR）1.83，95%CI：（0.65，5.12））和深静脉血栓形成发生率（RR 4.13，95%CI：（0.47，36.17））方面，止血带组与非止血带组之间无统计学差异（P＞0.05）。但在住院时间（MD 3.17，95%CI：（1.39，4.95））和关节活动范围（MD-5.25，95%CI：（-9.61，-0.89））方面，存在统计学意义。
总的来说，止血带组的疗效与非止血带组相当。非止血带组在关节活动范围方面获益更大，住院时间缩短。然而，未来仍需要更多的原始研究来评估止血带在踝关节创伤手术中的疗效。
