PTED与FD治疗腰椎间盘突出症的Meta分析  

Meta Analysis of PTED Versus FD in Treatment of Lumbar Disc Herniation

作　　者：吕浩源 肖强兵[1,2] 张艳佶 陈旻星 朱天娇[1] 宋虎[1] 

机构地区：[1]湖北中医药大学,武汉430065 [2]湖北省中医院

出　　处：《中国中医骨伤科杂志》2017年第6期23-28,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:通过Meta分析比较经皮椎间孔镜椎间盘切除术(PTED)与后路开放减压腰椎间盘切除术(FD)治疗腰椎间盘突出症的手术指标及疗效。方法:计算机检索Pubmed,EMbase,Cochrane Library,中国生物医学文献数据库(CBM),中国期刊全文数据库(CNKI)以及万方数据知识服务平台(WANFANG),维普中文科技期刊数据库(VIP)等权威数据库,手工检索相关杂志,用NOS量表(The Newcastle-Ottawa Scale)进行评分,按照标准纳入随机对照试验,采用Cochrane协作网提供的RevMan5.3软件进行数据分析。结果:共纳入21篇论文,1 564例患者,其中PTED组839例,FD组725例。PTED在出血量、切口长度以及卧床时间上具有明显的优势,但FD作为传统经典的术式,可缩短手术时间。另外,在疗效评估方面,FD和PTED的VAS指数并没有明显差异,但PTED远期ODI指数较FD好,可认为最终疗效方面PTED具有一定优势。结论:PTED与FD均为目前流行的术式,但有不同特点,临床可根据具体情况进行选择。Objective： To compare the efficacy of percutaneous transforaminal endoscopic discectomy（PTED）versus fenestration discectomy（FD）in the treatment of Lumbar disc herniation（LDH）. Methods： The randomized controlled trials（RCT）for comparing PTED and FD in the treatment of LDH were retrieved from MEDLINE, EMbase, Pubmed,Cochranc library, CBM,CNKI,WANFANG and VIP databases by computer. The related orthopedic documents were collected by manual retrieval, all the dates is rated by NOS Scale（The Newcastle-Ottawa Scale）,the RevMan5.3 statistical software（supplied by Cochrane collaboration）was used for conducting the meta analysis. Results： Twenty-one RCTS are included, involving 1564 patients, in which 839 cases are treated with PTED and 725 cases with FD. To compare the two surgical methods, PTED has the obvious advantages on Hospital stay, Blood loss, Incision length and bedridden time, but as a classic surgical method, FD can shorten the operation time. In terms of efficacy evaluation, the VAS indexes of FD and PTED show no difference, but long-term ODI index of FD is better than that of PTED. It＇s thought that PTED having better final efficacy than FD. Conclusion： Both PTED and FD are the most popular surgical methods, but they have different characteristics, which can be chose in clinic according to the specific situation.

关 键 词：腰椎间盘突出症 经皮椎间孔镜椎间盘切除术 腰椎后路椎板开放减压腰椎间盘切除术 META分析 

分 类 号：R681.5[医药卫生—骨科学]