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华西医学  2015 

关节镜下肱二头肌腱切除及固定术与肱二头肌腱修补术对肩关节上盂唇前后部损伤疗效的Meta分析

DOI: 10.7507/1002-0179.20150125, PP. 426-431

Keywords: 肱二头肌腱切除及固定术,肱二头肌腱修补术,肩关节上盂唇前后部损伤,系统评价,Meta分析,随机对照试验

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Abstract:

目的?系统评价关节镜下肱二头肌腱切除及固定术与肱二头肌腱修补术比较治疗肩关节上盂唇前后部(SLAP)损伤的疗效。方法?计算机检索PubMed、EMbase、Cochrane图书馆(2014年3期)、中国生物医学文献数据库、维普网和中国期刊全文数据库,检索时间均为各数据库建库至2014年12月,并手工检索国内外已发表的有关骨科论文及会议资料,收集肱二头肌腱切除及固定术与肱二头肌腱修补术比较治疗肩关节SLAP损伤疗效的随机对照试验(RCT),由2名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用采用Cochrane协作网提供的RevMan5.0软件进行Meta分析。结果?最终纳入3个RCT,共计137例患者,Meta分析结果显示与肱二头肌腱修补术相比,肱二头肌腱切除及固定手术治疗肩关节SLAP损伤UCLA肩关节评分WMD=3.43分,95%CI(2.29,4.56)分,P<0.00001、术后肩关节疼痛程度WMD=1.18分,95%CI(0.30,2.05)分,P=0.009、术后肩关节功能评价WMD=0.96分,95%CI(0.51,1.41)分,P<0.0001以及术后患者满意度的评价WMD=1.16分,95%CI(0.31,2.01)分,P=0.007更优异,而两组在上肢前屈活动度WMD=0.10分,95%CI(?0.87,1.06)分,P=0.84、上肢前屈肌力WMD=0.13分,95%CI(?0.09,0.35)分,P=0.25的评分方面,其差异均无统计学意义。结论?肱二头肌腱切除及固定术治疗肩关节SLAP损伤疗效优于肱二头肌腱修补术。由于纳入研究数量有限且方法学质量不高,研究结果尚需更多高质量的RCT进一步证实。

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