Meta Analysis Of The Effect Of End To Side Anastomosid On The Repair Of Nerve Injury In Animals And People

Objective:To evaluate the efficacy of the method of evidence-based medicine and meta analysis for the treatment of peripheral nerve injury.Methods:Inclusion and exclusion criteria were based on PICO principle(Participant,Intervention,Comparator,Outcome).All public relevant randomized controlled trials were retrieved in a computerized search of Pubmed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, wanfang Data system, VIP,China Biomedical Database and google scholar. Two investigators filtered the literature, evaluated the retrieved RCTs and collected data independently. The quality assessment of RCTs were based on Jadad scale and allocation concealment classification from Cochrane Library. Gait changes, peroneal nerve conduction velocity, anterior tibial muscle wet weight, Rev Man5.3 anterior tibial muscle wet weight ratio, nerve function score(MS) provided by the Cochrane Collaboration of software for data of evidence-based medicine and meta analysis research, All analyses were completed with Review Manager Software 5.3. For dichotomous data, relative risk(RR) and 95% confidence interval(CI) were calculated, while for continuous variables, weighted mean difference(WMD) and 95% confidence interval(CI) were calculated. Heterogeneity test was conducted before data merging: if I2 <50%,the Fixde-effect model was applied;if I2≥50%,the random-effect model was applied. Using statistical software SPSS 13, the superior rate of end to side anastomosis of different parts of nerve was performed with Kruskal-Wallis H.Results:According to the inclusion criteria and exclusion criteria for Meta analysis, animal experiment showed that the end to side anastomosis group gait coordination change rate is higher than the nerve graft group, the difference was statistically significant; end to side anastomosis group muscle wet weight recovery rate and lower incidence rate of anastomosis group, the difference was statistically significant; transplantation group of motor nerve conduction the speed of nerve end to side anastomosis group and no statistical significance; end to side anastomosis group number of nerve fiber recovery rate and lower incidence of nerve graft group, the difference was statistically significant; end to side anastomosis group does not change the incidence of gait coordination than the anastomosis group, the difference was statistically significant; end to side anastomosis of anterior tibial muscle wet weight recovery group the incidence rate is lower than the anastomosis group, the difference was statistically significant; anastomosis group of motor nerve conduction velocity recovery rate is lower than the end to side anastomosis group, There was a statistically significant difference; end to side anastomosis groups of motor nerve conduction velocity recovery and lower incidence of end to end anastomosis group, the difference was statistically significant; end to side anastomosis group gait coordination and lower incidence of nerve anastomosis group, the difference is statistically significant; end to side anastomosis of anterior tibial muscle wet weight recovery rate was higher than that of nerve anastomosis group, the difference is statistically significant. According to the inclusion criteria and exclusion criteria were included in the meta-analysis, clinical research results show: end to side anastomosis repairing peripheral nerve injury, excellent score of neural function occurrence rate is lower than the nerve graft group, the difference is statistically significant; end to side anastomosis for the treatment of radial nerve, ulnar nerve, sural nerve were statistically analyzed, P=0.039<0.05, the difference is statistically significant, and repair of radial nerve excellent rate was the highest.Conclusion:1.peripheral nerve injury, end to side anastomosis can be used as a choice of repair method;2.end to side anastomosis can promote the movement and sensory function recovery, but the effect is less than the end of the end anastomosis and nerve graft, better than the treatment;3.end to side anastomosis of the regenerative nerve helps to improve the recovery of muscle wet weight, a certain degree of reduction of muscle atrophy;4.end to side anastomosis to repair different parts of the nerve injury.