经皮椎间孔镜下髓核摘除与开窗髓核摘除治疗腰椎间盘突出症疗效比较的meta分析  

Comparison of curative effect between percutaneous transforaminal endoscopic discectomy and fenestration discectomy in the treatment of lumbar disc herniation:a meta analysis

作　　者：邢伟园 匡正达[1] 邹小丽[2] 杜明奎[1] XING Weiyuan KUANG Zhengda ZOU Xiaoli DU Mingkui(The Third Department of Orthopedics, General Hospital of Chinese People＇s Armed Police Force, Beijing 100039, China Department of Orthopaedics, China-Japan Union Hospital of Jilin University, Changchun 130033, China)

机构地区：[1]武警总医院骨三科,北京100039 [2]吉林大学中日联谊医院骨科,长春130033

出　　处：《中华灾害救援医学》2017年第1期36-40,共5页Chinese Journal of Disaster Medicine

摘　　要：目的比较经皮椎间孔镜髓核摘除术(percutaneous transforaminal endoscopic discectomy,PTED)与传统开窗髓核摘除术(fenestration discectomy,FD)治疗腰椎间盘突出症(lumbar disc herniation,LDH)的手术疗效,为椎间孔镜技术的临床应用提供循证医学证据。方法计算机检索Pub Med数据库、Cochrance图书馆、中国知网(CNKI)数据库、中国学术期刊数据库(万方数据库),查找有关椎间孔镜下髓核摘除与开放手术髓核摘除临床疗效比较的相关文献,采用Rev Man5.2软件进行数据分析,采用术后腰腿痛视觉模拟评分(visual analogue scale,VAS)、术后Oswestry功能障碍指数(Oswestry disability index,ODI)、手术时间、术中出血量及术后住院时间为临床疗效评价指标。结果共检索出相关文献280篇,最后纳入5篇,共398例,其中PTED组199例,FD组199例。与FD组比较,PTED组的术后ODI评分、术中出血量及术后住院时间均优于后者(P<0.05);但在术后腰腿疼VAS评分及手术时间上,两者差异无统计学意义。结论在LDH手术治疗中,PTED与FD疗效相近,但在术中出血量及术后住院时间方面,PTED具有创伤小、恢复快的优势。Objective The study aimed to compare the operative effect between percutaneous transforaminal endoscopic discectomy （PTED） and versus fenestration discectomy （FD） in the treatment of lumbar disc herniation （LDH）, to provide reference of evidence-based medicine for clinical application of PTED. Methods A retrospective study by means of literature review of PubMed data, Cochranee library, China National Knowledge Infrastructure （CNKI） and Wanfang data regarding the comparison of the curative effect between percutaneous transforaminal endoscopic discectomy and fenestration discectomy was conducted. Data was analyzed by RevMan 5.2 software. Postoperative visual analogue score （VAS）, postoperative Oswestry disability index （ODI）, operation time, blood loss and hospitalization time were used as clinical outcome assessments indexes. Results A total of 280 trials were retrieved, 5 trials involving 398 patients were included and 199 cases were treated by PTED, 199 cases were treated by FD. Compared with the FD group, postoperative ODI, blood loss and hospitalization time in the PTED group was significantly lower （P〈0.05）. There was no significant difference between PTED and FD in postoperative VAS and operation time. Conclusions In the surgical treatment of LDH, PTED and FD have the similar efficacy, however PTED has the advantage of less injury and blood loss resulting in a quicker recovery and less hospitalization time.

关 键 词：经皮椎间孔镜髓核摘除术 开窗髓核摘除 腰椎间盘突出 

分 类 号：R681.5[医药卫生—骨科学]