Chen Hong-wei, Ou Shan, Liu Guo-dong, Fei Jun, Zhao Gang-sheng, Wu Li-jun, Pan Jun
Department of Orthopedics, Central Hospital of Yiwu City, Yiwu 322000, China.
Department of Anesthesiology, General Hospital of Chengdu Military Command, Chengdu 610083, China.
Clin Neurol Neurosurg. 2014 Nov;126:150-5. doi: 10.1016/j.clineuro.2014.08.005. Epub 2014 Aug 11.
The aim of this study was to evaluate the clinical efficacy of simple decompression (SD) versus anterior transposition (AT) of the ulnar nerve for the treatment of cubital tunnel syndrome.
Seven public databases (PubMed, MEDLINE and EMBASE, Springer, Elsevier Science Direct, Cochrane Library and Google scholar) were searched from 1971 to December 2013. The overall odds ratios (OR) and their 95% confidence intervals (CI) were pooled to compare the clinical outcomes. Subgroup analysis was performed based on the region, study type, Jadad score, type of AT, and follow-up duration. Meta-analysis was conducted by using Rev. Man 5.1 and Stata 11.0 software.
Finally, we included 13 studies involved 1009 (500 patients receiving SD and 509 patients receiving AT) patients with cubital tunnel syndrome. The overall estimate (OR=0.91, 95% CI=0.67-1.23, P=0.536) indicated that there was no significantly statistical difference between the clinical outcomes of patients treated with SD and AT. Meanwhile, subgroup analyses by region, study type, Jadad score, type of AT and follow-up duration showed the consistent results with the overall estimate. In addition, we found that the incidence of complications in patients treated by SD was significantly lower than that in patients treated by AT (OR=0.32, 95% CI=0.17-0.60, P=0.05).
In conclusion, although SD had equivalent clinical outcomes with AT for the treatment of cubital tunnel syndrome, SD should be preferred due to having lower incidence of complications.
本研究旨在评估单纯减压(SD)与尺神经前置术(AT)治疗肘管综合征的临床疗效。
检索了1971年至2013年12月的七个公共数据库(PubMed、MEDLINE和EMBASE、Springer、Elsevier Science Direct、Cochrane图书馆和谷歌学术)。汇总总体比值比(OR)及其95%置信区间(CI)以比较临床结果。基于地区、研究类型、Jadad评分、AT类型和随访时间进行亚组分析。使用Rev. Man 5.1和Stata 11.0软件进行荟萃分析。
最终,我们纳入了13项研究,涉及1009例肘管综合征患者(500例接受SD,509例接受AT)。总体估计值(OR=0.91,95%CI=0.67-1.23,P=0.536)表明,接受SD和AT治疗的患者临床结果之间无显著统计学差异。同时,按地区、研究类型、Jadad评分、AT类型和随访时间进行的亚组分析结果与总体估计一致。此外,我们发现接受SD治疗的患者并发症发生率显著低于接受AT治疗的患者(OR=0.32,95%CI=0.17-0.60,P=0.05)。
总之,虽然在治疗肘管综合征方面SD与AT临床疗效相当,但由于并发症发生率较低,应优先选择SD。