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目的通过国内现有的相关文献进行Meta分析以比较儿童肱骨髁上骨折手法复位石膏外固定术和切开复位内固定术这两种治疗方法的疗效。方法根据纳入排除标准,摘录9篇NRCT文献中有关试验设计、研究对象的特征、研究结果等内容,用Rev Man5.1软件进行分析。结果儿童肱骨髁上骨折手法复位石膏外固定术和切开复位内固定术总体上差异不明显;后者的肘内翻发生率(OR=1.70,95%CI:1.04-2.76,P=0.03)低于前者,差异有统计学意义。但前者的优良率(OR=0.67,95%CI:0.41-1.09,P=0.11)、神经损伤发生率(OR=0.32,95%CI:0.07-1.45,P=0.14)、骨筋膜室综合症发生率(OR=2.06,95%CI:0.58-7.31,P=0.26)与后者相比差异无统计学意义。结论上述两种治疗方法疗效并无明显差异,手法复位石膏外固定术操作简易、住院周期短、关节功能恢复较快,在降低并发症发病率方面并无明显优势。因此在实际临床工作中应根据不同情况实施个体化治疗。
Objective To compare the curative effect of two methods of external fixation with gypsum and open reduction and internal fixation by means of Meta-analysis of the existing relevant literature in our country. Methods Based on the included exclusion criteria, 9 articles of NRCT were extracted and analyzed about the design of the trial, the characteristics of the research object and the results of the study. The results were analyzed by Rev Man 5.1 software. Results There was no significant difference in manual fixation of humeral supracondylar fractures between gypsum external fixation and open reduction and internal fixation. The incidence of cubitus varus in the latter group (OR = 1.70, 95% CI: 1.04-2.76, P = 0.03) Lower than the former, the difference was statistically significant. (OR = 0.67,95% CI: 0.41-1.09, P = 0.11), the incidence of nerve injury (OR = 0.32, 95% CI: 0.07-1.45, P = 0.14) The incidence of disease (OR = 2.06, 95% CI: 0.58-7.31, P = 0.26) was not significantly different from the latter. Conclusion There is no significant difference between the above two treatment methods. Manual reduction plaster external fixation is easy to operate, hospitalization is short, and joint function is recovered quickly. There is no obvious advantage in reducing the incidence of complications. Therefore, in the actual clinical work should be based on the implementation of individualized treatment.