文献阅读｜单房性骨囊肿的治疗:系统回顾和Meta分析
Treatment of Unicameral Bone Cyst: Systematic Review and Meta Analysis
Muayad Kadhim 1 , Mihir Thacker, Amjed Kadhim, Laurens Holmes Jr
J Child Orthop. 2014 Mar;8(2):171-91. doi: 10.1007/s11832-014-0566-3.
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Abstract
Purpose: Different treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities.
Methods: We utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome.
Results: Sixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7-101.8).
Conclusions: Active treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.
重点词汇汇总：
Unicameral /ˌjuːnɪˈkæmərəl/单房；单院的；一院制的
modalities形式；形态（modality的复数）；样式/moʊˈdæləti/
utilize /ˈjuːtəlaɪz/vt. 利用
the optimal treatment is controversial.最佳治疗方法是有争议的。
quantitative systematic review定量系统评价
retrospective studies回顾性研究 /ˌretrəˈspektɪv/
cumulative/ˈkjuːmjəleɪtɪv/adj. 累积的
ratio /ˈreɪʃioʊ/n. 比率，比例
methylprednisolone acetate (MPA) 醋酸甲泼尼龙
comparable to 可比较的，比得上的；相差无几
demineralized脱钙
curettage /ˌkjʊrɪˈtɑːʒ/n. [妇产] 刮除术，刮治术
autograft or allograft 自体或异体（骨）移植 /'æloɡræft/. [病理] 同种异体移植物
flexible intramedullary nails 弹性髓内征针
continuous decompression持续减压
cannulated screws 空心螺钉 /'kænjulit, -leit/adj. 筒状的（等于cannular）vt. 插管
Conservative treatment保守治疗 /kənˈsɜːrvətɪv/n. 保守派，守旧者adj. 保守的
favorable/'fevərəbl/adj. 有利的；良好的；赞成的，赞许的；讨人喜欢的
heterogeneity /ˌhetərədʒəˈniːəti/n. [生物] 异质性；[化学] 不均匀性；[化学] 多相性
reporting bias报告偏倚
谷歌翻译：
摘要
目的：单房性骨囊肿(UBC)有不同的治疗方法，但没有充分的证据支持一种治疗方法优于另一种治疗方法，最佳治疗方法也存在争议。这项定量系统评价的目的是评估不同UBC治疗方式的有效性。
方法：我们利用Pubmed对接受各种治疗的UBC患者进行回顾性研究。纳入的研究需要至少有15名患者的样本量，并提供了关于放射学愈合结果的数据。
结果：从463篇文献中筛选出62篇进入荟萃分析。累积样本量为3211例患者，3217例UBC，男女之比为2.2：1。醋酸甲泼尼龙(MPA)注射的总体或总体估计治愈率为77.4%，与骨髓注射的治愈率(77.9%)相当。当内壁破裂时，注射MPA的愈合率较高。脱钙骨基质注射对骨髓池的估计较高(98.7%)。无论使用自体移植物还是异体移植物，手术刮除后的UBC愈合率相当(90%)。UBC使用弹性髓内征针不刮除的愈合率几乎为100%，而空心螺钉持续减压的愈合率为89%。保守治疗治愈率64.2%，95%可信区间(2 6.7~101.8)。
结论：UBC的积极治疗提供了不同的愈合率，其结果相对于保守治疗是有利的。由于研究的异质性和报道的偏差，对这些发现的解释应该谨慎处理。