卢　巍　谭　为　李建平　蒋振东　杨　琳.遵义医学院珠海校区解剖学教研室，广东珠海　5904；.南方医科大学第三附属医院儿童骨科，广东广州　50630

肩关节脱位合并肱骨大结节骨折不同方法治疗的Meta分析

卢巍1谭为2李建平1蒋振东1杨琳1
1.遵义医学院珠海校区解剖学教研室，广东珠海519041；2.南方医科大学第三附属医院儿童骨科，广东广州510630

目的 肩关节脱位在关节脱位中较常见，关于其采取保守或手术治疗存在较多争议，本文就此评价两种治疗方案，探讨各方案适用性。方法 手动或计算机检索研究数据库及文献数据库，搜集手术疗法与保守疗法治疗肩关节脱位的随机对照试验，检索时限为2000年1月～2016年3月。按纳入及排除标准筛选文献，严格评价各研究的方法学质量，收集并整理资料，采用RevMan 5.3软件进行Meta分析。结果 经筛选评价后纳入4个研究，样本量156例。统计结果显示，采取保守与手术治疗肩关节脱位的ASES评分无差异［P=0.48，95%CI（-1.53，0.72）］。保守治疗患者较手术治疗患者并发症发病率低［P=0.04，95%CI（0.42，0.98）］。结论 保守与手术治疗无明显差异，两者效果相当，应结合患者具体情况选择治疗方案。

肩关节脱位；Mata分析；保守治疗；手术治疗

［Abstract］Objective To evaluate conservative therapy and surgical therapy in treatment of shoulder dislocation，which is commonly observed in dislocation of joints，and to discuss the applicability of each therapy.Methods Research database and literature database were retrieved manually or by computers to search randomized controlled trials of surgical therapy and conservative therapy in treatment of shoulder dislocation with a time limitation of January 2000 to March 2016.The literature was screened according to our inclusion and exclusion criteria to strictly evaluate the quality of methodology in each study and to collect and sort materials.RevMan 5.3 software was used to conduct Meta analysis. Results Four studies were enrolled after screening and evaluation，with a sample size of 156 cases.The statistical result showed that there was no significant difference in ASES scores between conservative and surgical therapy in treatment of shoulder dislocation［P=0.48，95%CI（-1.53，0.72）］.The incidence rate of complications was lower in patients with conservative therapy than those with surgical therapy［P=0.04，95%CI（0.42，0.98）］.Conclusion There is no significant difference between conservative therapy and surgical therapy，with comparable effects，the two therapies should be selected based on the particular condition of patients.

［Key words］Shoulder dislocation；Meta analysis；Conservative therapy；Surgical therapy

肩关节脱位在临床关节脱位中位列第一［1］，通常有多种并发症，包括肩袖、神经损伤或肱骨大结节骨折［2］。临床上初发性的肩关节脱位多以保守治疗为主，如多次肩关节脱位复发后必须手术治疗［3］。近年来，随着对肩关节损伤问题及其生物力学等问题的研究，对选择手术治疗还是保守治疗有不同意见。……