摘要 目的 评价骨填充网袋术（BFC）与经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折（OVCF）的疗效与安全性。 方法 检索PubMed、Web of Science、Cochrane Library、中国知网、维普、中国生物医学文献服务系统和万方数据库，查找BFC经皮椎体成形术与PKP治疗OVCF比较的随机对照试验（RCT）或病例对照研究（CCT）。检索时限均为建库至2019年9月。由2名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后，采用RevMan 5.3软件进行Meta分析。评价指标包括文献检索结果和纳入研究的基本特征、手术时间、术后视觉模拟评分（VAS）、术后Oswestry功能障碍指数（ODI）、术后Cobb角和术后骨水泥渗漏率和发表偏倚。结果 纳入5篇RCT和5篇CCT，共668例患者。在术后VAS（MD=-0.06, 95％ CI -0.24~0.37）、术后ODI（MD=-0.20, 95％ CI -1.13~0.73）及Cobb角（MD=0.18, 95％ CI -0.05~0.91）方面，BFC与PKP差异均无统计学意义(P>0.05)；但在手术时间（MD=-3.07, 95％ CI -5.53~-0.60）及骨水泥渗漏率（OR=0.21, 95％ CI 0.12~0.36）方面差异有统计学意义(P<0.01)。漏斗图显示以上指标皆无明显非对称性，提示发表偏倚对结果造成影响较小。 结论 BFC与PKP在治疗OVCF的手术疗效上相当，但有手术时间短和骨水泥渗漏率低的优势。
Abstract：Objective To assess the effect and safety of bone-filling mesh container (BFC) and percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fractures (OVCF). Methods PubMed, Web of Science, Cochrane Library, CNKI, VIP, CBM and Wanfang database were searched by computer from inception to September 2019, for the randomized controlled trial (RCT) or casecontrol trial (CCT) that compared the treatment of OVCF using BFC and PKP. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan 5.3. The literature search results, basic characteristics of the included studies, operation time, postoperative visual analogue score (VAS), Oswestry disability index (ODI), Cobbs angle, leakage rate of the bone cement and publication bias were evaluated. Results Only 5 RCTs and 5 CCTs involving 668 patients were included. Compared with the PKP group, the BFC group showed no significant difference in postoperative VAS (MD=-0.06, 95％ CI -0.24-0.37), ODI (MD=-0.20, 95％ CI -1.13-0.73) and Cobbs angle (MD=0.18, 95％ CI -0.05-0.91), while there were significant differences in operation time (MD=-3.07, 95％ CI -5.53--0.60) and leakage rate (OR=0.21, 95％ CI 0.12-0.36). Funnel plots showed that there was no significant asymmetry among the above indicators, suggesting that publication bias had little effect on the results. Conclusion BFC is as effective as PKP in the postoperative efficacy of OVCF, but is superior in operation time and leakage rate of bone cement.
吴宏梓 汪少波 拉华欠 廖燚. 骨填充网袋术治疗骨质疏松性椎体压缩骨折疗效与安全性的Meta分析[J]. 中华创伤杂志, 2020, 36(5): 433-441.
Wu Hongzi, Wang Shaobo, La Huaqian, Liao Yi.. Efficacy and safety of bone-filling mesh container in treatment of osteoporotic vertebral compression fractures：a meta-analysis. CHINESE JOURNAL OF TRAUMA, 2020, 36(5): 433-441.
