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[目的]用Meta分析的方法研究病灶内刮除+单纯骨水泥填充术与骨水泥填充联合石炭酸烧灼术治疗骨巨细胞瘤,并对术后复发率和并发症发生率进行综合分析。从而为骨巨细胞瘤外科治疗方法的选择提供合理的选择依据。[方法]收集已经公开发表的有关病灶内刮除+单纯骨水泥填充术与骨水泥填充联合石炭酸烧灼术治疗骨巨细胞瘤所有随访严密的随机对照研究(RCT)或设计良好的非随机对照研究,按照Meta分析的要求对检索到的原始文献进行质评。使用专用统计软件RevMan 5.1版对符合条件的所有研究结果进行Meta分析,分别计算病灶内刮除+单纯骨水泥填充术相对于骨水泥填充联合石炭酸烧灼术的复发情况及并发症发生危险的优势比(OR),评价两种术式术后对骨巨细胞瘤患者的复发率和并发症发生的影响。[结果]符合纳入标准的文献5篇,总样本量512例,其中病灶内刮除+单纯骨水泥填充术组310例,复发118例,出现并发症13例;骨水泥填充联合石炭酸烧灼术组202例,复发49例,出现并发症7例;合并OR复发=1.29,95%置信区间0.71~2.13,合并OR复发病理性骨折=1.39,95%置信区间0.43~4.53,合并OR复发软组织侵袭=2.43,95%置信区间0.64~9.29。[结论]两种手术治疗方式对术后并发症发生的影响有统计学意义,病灶内刮除术+单纯骨水泥填充术组的并发症发生风险比骨水泥填充联合石炭酸烧灼术组高1.23倍。
[Objective] To study the treatment of giant cell tumor of giant cell tumor of bone with curettage plus simple cement-cementation and bone cement filling combined with carbolic acid cauterization by Meta-analysis. The postoperative recurrence rate and complication rate were analyzed comprehensively. So as to provide a reasonable basis for the selection of surgical treatment of giant cell tumor of bone. [Methods] We have published randomized controlled trials (RCTs) or well-designed nonrandomized controlled trials of well-published randomized controlled trials (RCTs) that have been published publicly for the treatment of giant cell tumor of the giant cell tumors of the giant cell tumor of the bone with curettage plus mere cement augmentation versus bone cement fill plus carbolic acid cautery , In accordance with the requirements of Meta analysis of the quality of the original documents retrieved. Meta-analysis was performed on all the eligible results using the RevMan version 5.1 of the proprietary statistical software to calculate the recurrence rate and the odds ratio for the risk of complications associated with the curettage of the lesion versus the simple cement-filled versus the cement-bound and carbolic acid cautery respectively (OR) to evaluate the effect of two kinds of operation on the recurrence rate and complications of patients with giant cell tumor of bone. [Results] There were 5 articles with the inclusion criteria and the total sample size was 512 cases, of which 310 cases were cured by curettage + simple cement-filled surgery, 118 cases were recurrence and 13 cases were complicated by complications. The bone cement-filled combined with carbolic acid cautery 202 cases, recurrence in 49 cases, complications occurred in 7 cases; OR recurrence = 1.29,95% confidence interval 0.71 ~ 2.13, with OR recurrence pathological fracture = 1.39, 95% confidence interval 0.43 ~ 4.53, OR recurrence of soft tissue invasion = 2.43, 95% confidence interval 0.64 ~ 9.29. [Conclusion] The two surgical methods have a significant effect on the incidence of postoperative complications. The risk of complication of intralesional curettage group + simple cement-filled group was 1.23 times higher than that of bone cement-filled combined with carbolic acid cautery group .