摘要
目的比较经皮椎体成形术(PVP)与保守治疗治疗骨质疏松性椎体压缩骨折的疗效。方法收集所有PVP与保守治疗治疗骨质疏松性椎体压缩骨折的随机对照研究(RCT),前瞻性临床队列研究(CCT),对其逐个进行质量评价,作系统评价分析。结果共纳入3篇研究:1篇RCT,2篇CCT,共计288例患者。3个研究均对PVP与保守治疗进行疗效比较。在减轻疼痛方面,PVP组在术后1 d及至少2 w内优于保守组,但在远期效果上是否优于保守治疗缺乏证据。在相邻椎体新发压缩骨折方面,两种方法没有差别。在总体治疗效果上,由于使用了不同的评分方法,尚无法得出何种技术更为有效的结果。在止痛药物的使用上,也无法得出PVP组少于保守治疗组的结论。结论PVP与保守治疗均是治疗骨质疏松性椎体压缩骨折的有效治疗方法,但近期疼痛缓解PVP组优于保守组。在评价其他结局指标方面,缺乏足够的证据,尚需更多设计严格的研究以增加证据的强度。
Objective To evaluate the effectiveness of percutaneous vertebroplasty versus conservative treatment of older osteoporotic vertebral compression fractures.Methods All RCTs and CCTs of percutaneous vertebroplasty versus conservative treatment of osteoporotic vertebral compression fractures were identified.Two reviewers assessed the quality of the trials and extracted data independently.Results Three published trials including a total of 288 patients were included.All studies compared percutaneous vertebroplasty with conservative treatment.It was clear that,compared with conservative treatment,percutaneous vertebroplasty treatment is associated with less pain on the first day and at least two weeks,but there is not possible evidence in long term outcome.For the outcome of new vertebral compression fractures in adjacent vertebral bodies,there was no difference between treatment methods.For the outcome of function,a meta-analysis could not be performed because they use different score criteria.For the outcome of Analgesic use,there is not possible evidence to prove that percutaneous vertebroplasty treatment is better than conservative treatment.Conclusion Both percutaneous vertebroplasty and conservative treatment appear to produce comparable long term outcomes in treating osteoporotic vertebral compression fractures.Percutaneous vertebroplasty group is associated with less pain.Because of poor reporting of outcomes,it is not possible to determine if any significant difference in other outcome measures do exist.More trials with high quality on methodology are needed.
出处
《中国骨质疏松杂志》
CAS
CSCD
2008年第6期396-401,共6页
Chinese Journal of Osteoporosis
关键词
骨质疏松
椎体压缩性骨折
经皮椎体成形术
保守治疗
系统评价
Osteoporotic
Vertebral compression fractures
Percutaneous vertebroplasty
Conservative treatment
Systematic review
