摘要
目的 评估体外冲击波疗法(ESWT)在前交叉韧带重建术(ACLR)术后康复中的疗效。方法 系统检索PubMed、Embase、Web of Science和Cochrane Library等英文数据库,以及中国知网(CNKI)、万方(WanFang)、维普(VIP)等中文数据库(截至2025年1月),纳入关于ESWT在ACLR术后康复中应用的随机对照试验(RCT)。比较ESWT组与对照组的Lysholm评分和IKDC评分差异。结果 共计纳入9篇研究,共计受试者486例,其中ESWT组248例,对照组238例。按照干预次数分为短期干预(≤3次)和长期干预(>3次),Meta分析结果表明,短期(≤3次)ESWT可以显著改善患者的Lysholm评分(MD=8.06, 95%CI:5.29~10.84)和IKDC评分(MD=6.46,95%CI:3.66~9.26),且干预次数是Lysholm评分的显著正相关调节因子。长期(>3次)ESWT对Lysholm评分改善有限(MD=4.58, 95%CI:-0.16~9.33),对IKDC评分有改善但效应量较小(MD=1.91, 95%CI:0.84~2.98)。此外,长期干预Lysholm评分和短期干预IKDC评分的效应量均不稳健,且结局指标的证据质量等级多为中低级。结论 ESWT是一种非侵入、成本效益高的治疗手段,可促进ACLR术后康复,尤其在短期应用中效果显著。
Objective To evaluate the efficacy of extracorporeal shock wave therapy(ESWT)in the rehabilitation after anterior cruciate ligament reconstruction(ACLR).Methods Systematic searches were conducted in English databases such as PubMed,Embase,Web of Science,and Cochrane Library,as well as Chinese databases such as CNKI,WanFang,and VIP(up to January 2025).Randomized controlled trials(RCTs)on the application of ESWT in the rehabilitation after ACLR were included.The differences in Lysholm scores and IKDC scores between the ESWT group and the control group were compared.Results A total of 9 studies were included,involving 486 subjects,with 248 cases in the ESWT group and 238 cases in the control group.According to the number of interventions,they were divided into short-term intervention(≤3 times)and long-term intervention(>3 times).Meta-analysis results showed that short-term ESWT could significantly improve the Lysholm scores(MD=8.06,95%CI:5.29-10.84)and IKDC scores(MD=6.46,95%CI:3.66-9.26),with the number of interventions being a significant positive moderator of Lysholm scores.Long-term ESWT showed limited improvement on the Lysholm scores(MD=4.58,95%CI:-0.16-9.33)and had modest improvements on the IKDC scores(MD=1.91,95%CI:0.84-2.98).In addition,the effect sizes of long-term Lysholm scores and short-term intervention on the IKDC scores were not stable,and the quality grades of the outcome indicators was mostly medium and low.Conclusions ESWT is a non-invasive and cost-effective treatment method that can promote the rehabilitation after ACLR,especially with significant effects in short-term application.
作者
高金卯
陆广旭
林彦琛
石晓莲
史菲
云晨
GAO Jinmao;LU Guangxu;LIN Yanchen;SHI Xiaolian;SHI Fei;YUN Chen(Weifang Detachment of Shandong Provincial Corps of Chinese People’s Armed Police Force,Weifang 261000,China;Department of Orthopedics,the Second Mobile Corps Hospital of Chinese People’s Armed Police Force,Wuxi 214000,China;Department of Rehabilitation,Research Department,Characteristics Medical Center of Chinese People’s Armed Police Force,Tianjin 300162,China;Department of Health Service,Shandong Provincial Corps Hospital of Chinese People’s Armed Police Force,Jinan 250000,China;Department of Emergency,Shandong Provincial Corps Hospital of Chinese People’s Armed Police Force,Jinan 250000,China;Institute of Maritime Rights Protection Medical Support,Research Department,Characteristics Medical Center of Chinese People’s Armed Police Force,Tianjin 300162,China)
出处
《武警医学》
2025年第11期926-933,共8页
Medical Journal of the Chinese People's Armed Police Force
基金
天津市卫生健康科技项目(TJWJ2022QN100)
关键词
体外冲击波疗法
前交叉韧带重建术
META分析
extracorporeal shock wave therapy
anterior cruciate ligament reconstruction
meta-analysis
