后路显微椎间盘镜与传统开窗手术治疗腰椎间盘突出症的Meta分析  

Meta-analysis of Microendoscopic discectomy versus Open lumbar discectomy treatment in patients with lumbar disc herniation

作　　者：郭二鹏[1,2] 李宽新[2] 李建柱[2] 孙开军[2] 史东[2] 王维山[1] 史晨辉[1,2] 

机构地区：[1]石河子大学临床医学院,新疆石河子832002 [2]石河子大学医学院第二附属医院脊柱外科,新疆乌鲁木齐832000

出　　处：《重庆医学》2015年第21期2935-2938,2943,共5页Chongqing medicine

基　　金：兵团科技创新团队专项基金(2014CC002);新疆兵团医药卫生专项资助课题(2013BA020);兵团国际交流与合作专项资助课题(2012BC002;2011BC004)

摘　　要：目的利用Meta分析方法系统评价后路显微椎间盘镜手术与传统开窗手术治疗单节段腰椎间盘突出症的临床疗效和安全性。方法计算机检索Cochrane Library、Medline、PubMed、Embase、中国期刊全文数据库、中国生物医学文献数据库、万方数据库(1997年1月至2014年9月),手工检索相关杂志。搜集后路显微椎间盘镜髓核摘除术和传统开窗腰椎间盘髓核摘除术治疗成人单节段腰椎间盘突出症的随机对照研究。将各研究中的手术后疗效、手术时间、术中失血量、住院时间等提取整理为电子基线表,并将这些研究的数据通过Rev Man5.1软件进行Meta分析与综合。结果共17篇研究符合标准,共计2 551例患者被纳入分析研究。Meta分析结果显示:后路显微椎间盘镜手术与传统开窗手术相比,术后疗效和手术操作时间方面差异无统计学意义(P>0.05);术中出血量、手术切口长度、术后卧床时间、住院时间及恢复日常生活时间方面差异有统计学意义(P<0.05)。结论与传统开窗手术治疗单节段腰椎间盘突出症相比,后路显微椎间盘镜手术在术后疗效和手术操作时间方面相当;后路显微椎间盘镜手术手术以其微创化优势,使其在术中出血量、手术切口长度、术后卧床时间、住院时间及恢复日常生活时间方面优于传统开窗手术。Objective To compare the efficacy and safety between microendoscopy discectomy and open lumbar discectomy m the treatment of lumbar disc herniation with recta-analysis. Methods Researches on comparison between one-level microendoscopic discectomy and open discectomy in adults world-wide with prospectiv~ data collection from the Cochrane Central Register of Con- trolled Trials,Med｜ine databases, Pubmed databases, Embase databases, CNKI databases, CBM databases and Wanfang databases （1997-01/2014-09） ,and several hand searched related journals were performed. Two authors independently assessed trial quality and extracted data into an electrical sheet. Data of the treatment outcome, operation time,intraoperative blood loss and length of hospital stay from these studies were abstracted and synthesized by a meta-analysis with Rev Man 5.1. Results Seventeen studies involving 2 551 cases were included. Results showed that： there were no significant differences in the treatment outcome and the op- eration time between MED group and OLD group; there were significant difference between MED group and OLD group in terms of intraoperative blood loss,size of incision.mean time in bed.length of hospital stay and time to return to daily life. Conclusion There were no significant differences in the treatment outcome and the operation time between microendoscopy discectomy and open lum- bar discectomy;but microendoscopy discectomy was superior to open lumbar discectomy in intraoperative blood loss. size of inci- sion,mean time in bed,length of hospital stay and time to return to daily life after operation.

关 键 词：随机对照试验 META分析 腰椎间盘突出症 后路显微椎间盘镜 开窗手术 

分 类 号：R687.3[医药卫生—骨科学]