王晓旭;刘珏;

• 1:南华大学附属第二医院关节骨科
• 2:南华大学循证医学教研室

摘要(Abstract)：

[目的]对微创小切口在全髋置换术中的应用进行系统评价。[方法]在Pubmed、Cochrane Library、EMBASE、Science Direct以及CNKI、CBM、中国医学学术会议论文数据库等网站进行检索。文献检索起止时间为2000年1月～2011年1月。再对入选文献的参考文献进行手工检索。系统收集微创小切口进行全髋置换的相关文献,并按临床科研方法的国际通用原则进行阅读和评价。采用Cochrane协作网提供的软件Revman 4.2进行Meta-分析,以获得微创小切口进行全髋置换的疗效及其安全性指标的相关证据。[结果]共检索到236篇原始文献,有6篇符合最终的入选标准,总计随访患者551例。研究显示微创小切口组在手术用时、术中失血量方面少于传统长切口,术后并发症发生率及住院时间无统计学意义。[结论]采用微创小切口在术中失血量、手术用时方面少于传统长切口;术后并发症及住院时间方面,两种切口的差异无统计学意义。因本研究的样本量较小,缺乏足够的证据,尚需更多设计严格的研究以增加证据的强度。

关键词(KeyWords)： 微创;传统切口;全髋关节置换术;随机对照试验;系统评价

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王晓旭;刘珏;

Email:

DOI:

参考文献(References)：

• [1]Bal BS,Haltom D,Aleto T,et al.Early complications of primary to-talhip replacement performed with a two-incision minimally invasivetechnique[J].J Bone Joint Surg Am,2005,87:2432.
• [2]Zhang XL,He YH,Wang Q,et al.Minimally invasive incision in to-tal hip arthroplasty for displaced femoral neck fractures in the elder-ly[J].Chin J Orthop Trauma,2004,6:506-508.
• [3]Yan ZQ,Chen YS,Yang Y,et al.Two-incision minimal invasive ap-proach for total hip replacement[J].Fudan Univ J Med Sci,2005,32:557-560.
• [4]Chimento GF,Pavone V,Sharrock N,et al.Minimally invasive totalhip arthroplasty:a prospective randomized study[J].J Arthroplasty,2005,20:139-144.
• [5]Ogonda L,Wilson R,Archbold P,et al.A minimal-incision tech-nique in total hip arthroplasty does not improve postoperative out-comes.A prospective,randomized,controlled trial[J].J Bone JointSurg Am,2005,4:701-710.
• [6]Kim YH.Comparison of primary total hip arthroplasties performedwith a minimally invasive technique or a standard technique:a pro-spective and randomized study[J].J Arthroplasty,2006,21:1092-1098.
• [7]Dorr LD,Maheshwari AV,Long WT,et al.Early pain relief andfunction after posterior minimally invasive and conventional total hiparthroplasty.A prospective,randomized,blinded study[J].J BoneJoint Surg Am,2007,89:1153-1160.
• [8]郭予立,史占军,景宗森,等.小切口全髋关节置换的手术体会[J].中国矫形外科杂志,2008,7:495-497.
• [9]Duwelius PJ,Dorr LD.Minimally invasive total hip arthroplasty:anoverview of the results[J].Instr Course Lect,2008,57:215-222.
• [10]van Oldenrijk J,Hoogland PV,Tuijthof GJ.Soft tissue damage afterminimally invasive THA[J].Acta Orthop,2010,6:696-702.
• [11]Fink B,Mittelstaedt A,Schulz MS.Comparison of a minimally inva-sive posterior approach and the standard posterior approach for totalhip arthroplasty.A prospective and comparative study[J].OrthopSurg Res,2010,5:46.