沈皆亮;郝杰;何斌;

• 1:重庆医科大学附属第一医院骨科
• 2:贵州省遵义市第一人民医院骨科二病区

摘要(Abstract)：

[目的]系统评价保守和手术治疗不伴神经损伤的胸腰椎爆裂骨折的有效性和安全性差异。[方法]计算机检索Pubmed、Embase、Cochrane图书馆、中国生物医学文献数据库(CBM)、万方数据及中国知网等6个常用的中英文电子数据库,收录有关保守和手术治疗不伴神经损伤的胸腰椎爆裂骨折的临床随机对照研究,检索文献截至2015年9月。按照纳入标准和排除标准限定研究对象,采用改良的Jadad评分量表进行文献质量评估,运用RevMan 5.3软件对提取的有效数据进行Meta分析。[结果]纳入4项临床随机对照研究,共计患者239人,最终完成随访212人,其中保守组112例,手术组100例,随访12~268个月。Meta分析显示无论接受保守还是手术治疗的患者,在治疗后疼痛感受(VAS评分)、功能恢复(RMDQ-24)及重返工作方面比较差异均无统计学意义,但手术组患者后凸畸形的改善明显优于保守组,而保守组在治疗后的并发症和医疗花费方面要优于手术组。[结论]对于不伴神经损伤的胸腰椎爆裂骨折无论是保守还是手术治疗,两者的中远期临床结果相似,保守治疗具有并发症低、医疗花费少等优势。但由于各研究起始年月较早,手术方式较为传统,近年来兴起的微创治疗等手段与保守治疗的对比尚需更多高质量的前瞻临床对照研究进一步增强循证依据。

关键词(KeyWords)： 胸腰椎爆裂骨折不伴神经损伤;保守治疗;手术治疗;Meta分析

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 沈皆亮;郝杰;何斌;

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DOI:

参考文献(References)：

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