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治疗感觉异常性股痛(股外侧皮神经病变):超声引导注射与手术治疗的荟萃分析。

Treatment of meralgia paresthetica (Lateral Femoral Cutaneous Neuropathy): A meta-analysis of ultrasound-guided injection versus surgery.

机构信息

IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy; Department of Health Sciences (DISSAL). University of Genoa, Genoa, Italy.

IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy.

出版信息

Eur J Radiol. 2021 Jun;139:109736. doi: 10.1016/j.ejrad.2021.109736. Epub 2021 Apr 26.

Abstract

PURPOSE

To compare ultrasound (US)-guided injections and surgery for the treatment of meralgia paresthetica (lateral femoral cutaneous neuropathy).

METHODS

Two reviewers, independently, up to 10 October 2020 retrieved Studies that assessed the outcome of US-guided injections and surgery for the treatment of meralgia paresthetica from major medical libraries. Predefined inclusion and exclusion criteria were adopted.

RESULTS

399 studies were initially found, and the meta-analysis was conducted on 10 studies for a total of 149 patients. US-guided injections were done in three studies, surgery in seven studies. N = 38 % (57/149) of patients were treated with US-guided injection and 62 % (92/149) were treated with surgery. After US-guided injections, 85 % (49/57) of patients were treated successfully, whereas 80 % (74/92) were treated with surgery successfully from the clinical point of view. Differences were not statistically significant even with a slight heterogeneity of studies and outcome pooled on random-effect model. No comparative cohort study or RCT was conducted.

CONCLUSION

This meta-analysis showed that there was no statistically significant difference in treatment of meralgia paresthetica with ultrasound-guided injection or surgery. A RCT to compare a standardized US-guided approach versus surgery is essential to compare these techniques properly.

摘要

目的

比较超声(US)引导下注射与手术治疗感觉异常性股痛(外侧股皮神经病变)。

方法

两位审阅者于 2020 年 10 月 10 日之前,从主要医学文库中独立检索评估 US 引导下注射与手术治疗感觉异常性股痛的结局的研究。采用了预先设定的纳入和排除标准。

结果

最初发现 399 项研究,对 10 项研究共 149 例患者进行了荟萃分析。三项研究中进行了 US 引导下注射,七项研究中进行了手术。38%(57/149)的患者接受 US 引导下注射治疗,62%(92/149)的患者接受手术治疗。US 引导下注射后,85%(49/57)的患者从临床角度来看治疗成功,而手术治疗的成功率为 80%(74/92)。即使存在研究和结局的轻度异质性,采用随机效应模型进行汇总,差异也无统计学意义。未进行比较队列研究或 RCT。

结论

本荟萃分析表明,US 引导下注射与手术治疗感觉异常性股痛在统计学上无显著差异。需要进行 RCT 比较标准化 US 引导方法与手术,以正确比较这些技术。

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