超声骨刀在脊柱手术中的有效性与安全性的Meta分析

    The Efficacy and Safety of Ultrasonic Bone Curette Application in Spinal Surgery: A Meta-Analysis

    • 摘要: 目的 通过Meta分析评价在脊柱手术中应用超声骨刀的有效性和安全性。 方法 计算机检索PubMed、EMBASE、中国知网、维普和万方数据库,搜集关于比较脊柱手术中应用超声骨刀与传统工具(如高速磨转等)的相关研究,检索时限均从建库至2017年1月1日。由2位评价员独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析。 结果 共纳入8个研究,纳入患者641例。Meta分析结果显示: 与传统工具相比,超声骨刀能够节省手术时间标准化均数差=-2.44,95%可信区间(-4.23, -0.66),P=0.007,减少术中出血量标准化均数差=-2.31,95%可信区间(-4.24,-0.38),P=0.02。但二者的住院时间标准化均数差=-0.00,95%可信区间(-1.22,1.21),P=0.99,症状改善率比值比=0.94,95%可信区间(0.43,2.10),P=0.89以及术后并发症比值比=0.96,95%可信区间(0.47,1.95),P=0.90差异无统计学意义。 结论 现有证据表明,在脊柱手术中应用超声骨刀安全有效,可以减少术中出血、节省手术时间,但与传统手术器械相比,在症状改善率、缩短住院日及术后并发症方面无明显差异。以上结论尚需更多高质量研究来证实。

       

      Abstract: Objective To evaluate the efficacy and safety of ultrasonic bone curette application in spinal surgery by meta-analysis. Methods Databases of PubMed, EMBASE, CNKI, VIP and Wanfang data were searched to collect studies that compared the efficacy and safety of ultrasonic bone curette versus conventional instruments in spinal surgery from inception to January 1st 2017. Two reviewers independently screened literature, extracted data, and evaluated the methodological quality of included studies. The meta-analysis was performed using RevMan 5.3 software. Results A total of 8 studies involving 641 patients were included. The results of meta-analysis showed that, compared with conventional instruments, ultrasonic bone curette could reduce operative time (SMD=-2.44, 95%Cl -4.23 to -0.66, P=0.007) and operative blood loss (SMD=-2.31, 95%CI -4.24 to -0.38, P=0.02). But no significant differences were found between two groups in hospitalization (SMD=-0.00, 95%CI -1.22 to 1.21, P=0.99), recovery rate (OR=0.94, 95%CI 0.43 to 2.10, P=0.89) and postoperative complications (OR=0.96, 95%CI 0.47 to 1.95, P=0.90). Conclusion The current evidence shows that ultrasonic bone curette application in spinal surgery is effective and safe, it can reduce operative time and operative blood loss. But compared with conventional instruments, ultrasonic bone curette has no significant advantages in hospitalization, recovery rate and complications. Due to the limited quality of the included studies, more studies are needed to verify the above conclusion.

       

    /

    返回文章
    返回