摘要
[目的]用Meta分析的方法探讨肥胖对初次人工全髋关节置换术(total hip arthroplasty,THA)临床疗效的影响。[方法]计算机检索数据库Pub Med、EBSCO、The Cochrane Library、Wan Fang、CNKI中关于肥胖对全髋关节置换术临床疗效的文献,检索时限为2016年8月1日之前。按纳入、排除标准进行前瞻性病例对照研究筛查,采用Newcastle Ottawa Scale(NOS)文献质量评价量表对文献进行质量评估,采用Rev Man 5.2软件进行Meta分析。[结果]纳入18篇文献,10 047例患者,肥胖组2 985例,非肥胖组7 062例。Meta分析结果显示:与非肥胖组相比,肥胖组可以显著增加THA手术时间(WMD=10.82,95%CI[4.83,16.82],P=0.000 4)、术后脱位率(RR=2.08,95%CI[1.55,2.79],P<0.000 01)、感染率(RR=3.68,95%CI[2.18,6.22],P<0.000 01)、失血量(WMD=169.14,95%CI[73.24,265.05],P=0.000 5),显著降低Harris Hip Score(HHS)评分(WMD=-3.40,95%CI[-5.41,-1.40],P=0.000 9);但两组住院时间(WMD=-0.19,95%CI[-0.38,-0.00],P=0.05)差异无统计学意义。[结论]肥胖增加人工全髋关节置换手术时间、失血量及术后脱位、感染并发症发生率,影响患者术后髋关节功能恢复。肥胖对初次人工全髋关节置换术临床疗效产生负面影响。
[Objective] To explore the influence of obesity on the outcomes of primary total hip arthroplasty. [Methods ] After formulating the inclusion and exclusion criteria, the following databases were searched, including PubMed, EBSCO, The Coch-rane Library, WanFang database and China National Knowledge Infrastructure （CNKI） before August 1, 2016. The Newcastle Ottawa Scale （NOS） was used for quality assessment of the included studies. Review Manager 5.2 software was used for meta-analysis. [Results] Eighteen eligible studies involving 10047 participants （2985 obese and 7062 non-obese） were included in our meta-analysis. The obese significantly suffered higher quantity of operative time （WMD= 10.82, 95%CI 4.83-16.82, P=0.000 4）, dislocation rate （RR=2.08, 95%CI 1.55-2.79, P〈0.001）, infection rate （RR= 3.68, 95%CI 2.18-6.22, P〈0.001） and bleeding volume （WMD=169.14, 95%CI 73.24-265.05, P=0.0005） compared with the non-obese. For the functional result, obese patients acquired relatively lower Harris Hip Score than non-obese pa- tients （WMD=-3.40, 95%CI -5.41--1.40, P=0.000 9） . However, no significant difference was found in the length of stay in hospital between the obese and non-obese groups （WMD=-0.19, 95%CI -0.38-0.00, P=0.05） . [Conclusion] Obesity may increase operative time and bleeding volume in total hip arthroplasty. Patients with obesity also have more postoperative complications including dislocation and infection than the non-obesity patients. Additionally the recovery of hip function could be affected by obesity in total hip arthroplasty. Obesity appears to have a negative impact on the outcome of total hip replacement.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2017年第13期1203-1209,共7页
Orthopedic Journal of China
基金
山东省自然科学基金(编号:ZR2015PH006)
作者简介
徐闯，硕士研究生，研究方向：骨关节外科，（电话）13256286972，（电子信箱）doctorxuchuang@163．com
通信作者：刘明廷，（电话）13954339667，（电子信箱）18865675365@163.com
