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一项荟萃分析比较了骨水泥型和非骨水泥型假体对股骨颈骨折患者伤口感染和疼痛的影响。

A meta-analysis comparing the effects of cemented and uncemented prostheses on wound infection and pain in patients with femoral neck fractures.

机构信息

Department of Osteology, Linfen People's Hospital of Shanxi Medical University, Linfen, China.

出版信息

Int Wound J. 2023 Dec;20(10):4122-4129. doi: 10.1111/iwj.14306. Epub 2023 Aug 9.

Abstract

To providing evidence-based recommendations for surgery in patients with femoral neck fractures, a meta-analysis was conducted to comprehensively evaluate the effects of cemented and uncemented prostheses on postoperative surgical site wound infection and pain in these patients. Relevant studies on the use of cemented prostheses in femoral neck fractures were retrieved from PubMed, EMBASE, Cochrane Library, Ovid, CNKI, and Wanfang databases from the time of their establishment until March 2023. Two authors independently screened and extracted data from the included and excluded literature according to predetermined criteria. Review Manager 5.4 software was used to perform meta-analyses on the collected data. A total of 27 articles comprising 34 210 patients (24 646 cases in the cemented group and 9564 cases in the uncemented group) were included in the final analysis. The results of the meta-analysis showed that, compared with the uncemented group, cemented prostheses significantly reduced the incidence of surgical site wound infections (odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.64-0.88, p < 0.001) and relieved surgical site wound pain (standardised mean difference: -0.76, 95% CI: -1.12-0.40, p < 0.001), but did not reduce the incidence of pressure ulcers after surgery (OR: 0.50, 95% CI: 0.20-1.26, p = 0.140). Therefore, existing evidence suggests that the use of cemented prostheses in femoral neck fracture surgery can significantly reduce the incidence of surgical site wound infections and relieve surgical site wound pain, which is worthy of clinical recommendation.

摘要

为了为股骨颈骨折患者的手术提供循证推荐,我们进行了一项荟萃分析,以全面评估骨水泥型和非骨水泥型假体对这些患者术后手术部位伤口感染和疼痛的影响。我们从 PubMed、EMBASE、Cochrane 图书馆、Ovid、中国知网(CNKI)和万方数据库中检索了关于股骨颈骨折中使用骨水泥型假体的相关研究,这些数据库的建立时间截至 2023 年 3 月。两位作者根据预定标准独立筛选和提取纳入和排除文献中的数据。我们使用 Review Manager 5.4 软件对收集的数据进行荟萃分析。最终分析共纳入 27 篇文章,包含 34210 例患者(骨水泥组 24646 例,非骨水泥组 9564 例)。荟萃分析结果显示,与非骨水泥组相比,骨水泥型假体可显著降低手术部位伤口感染的发生率(比值比 [OR]:0.75,95%置信区间 [CI]:0.64-0.88,p<0.001)和减轻手术部位伤口疼痛(标准化均数差:-0.76,95%CI:-1.12-0.40,p<0.001),但不会降低术后压疮的发生率(OR:0.50,95%CI:0.20-1.26,p=0.140)。因此,现有证据表明,在股骨颈骨折手术中使用骨水泥型假体可显著降低手术部位伤口感染的发生率,并减轻手术部位伤口疼痛,值得临床推荐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb3b/10681411/73c43b35ae7d/IWJ-20-4122-g001.jpg

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