椎间盘镜与椎间孔镜治疗腰椎间盘突出疗效比较的Meta分析  

Percutaneous endoscopic lumbar discectomy versus microendoscopic discectomy for lumbar disc herniation:a Meta-analysis

作　　者：凌华军[1] 范磊[2] 赖茂松[1] 林伟文[1] 熊浩[1] 罗鹏刚[1] 吴增志[1] 夏雄超[1] Hua-jun Ling;Lei Fan;Mao-song Lai;Wei-wen Lin;Hao Xiong;Peng-gang Luo;Zeng-zhi Wu;Xiong-chao Xia(Department of Orthopaedics and Traumatology, the People’s Hospital of Gaoming Distric, Foshan,Guangzhou 528500, China;Department of Spine Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510000, China)

机构地区：[1]广东省佛山市高明区人民医院骨二科,广东佛山528500 [2]中山大学附属第三医院脊柱外科,广东广州510000

出　　处：《中国内镜杂志》2017年第3期47-55,共9页China Journal of Endoscopy

摘　　要：目的比较椎间盘镜和椎间孔镜治疗腰椎间盘突出症的疗效。方法通过检索Pub Med、Web of Science、Embase、万方和中国知网5个数据库,由两位作者独立筛选出相关文章。运用Cochrane风险因素来评估随机对照试验(RCT)文章质量,运用修改的Newcastle-Ottawa量表进行回顾性文献的质量评估。文章中的数据应用Review Manager 5.3软件进行提取。结果最后有19篇相关研究被纳入此次Meta分析。椎间孔镜术后短期视觉模拟评分法(VAS)改善明显优于椎间盘镜组(P=0.010),而手术后远期VAS评分变化(P=0.120)、Oswestry功能障碍指数问卷表(ODI)评分变化(P=0.260)、并发症(P=0.100)和残留或复发率(P=0.100)比较,两组差异均无统计学意义。椎间孔镜组出血量更少(P=0.000),切口长度更短(P=0.000),住院天数更少(P=0.000),但是椎间孔镜的手术时间较椎间盘镜组长(P=0.001)。结论在椎间盘突出的手术治疗方面,经皮椎间孔镜技术无疑是一种更加微创且安全的手术方法。Objective To compare the curative effect of percutaneous endoscopic lumbar discectomy(PELD)and microendoscopic discectomy(MED)in lumbar disc herniation.Methods A literature search wasperformed in PubMed,Web of Science,Embase,Wanfang,CNKI.Two authors reviewed all articles individually.The methodological quality of RCTs was assessed by the Cochrane risk of bias tool,and the quality of retrospectivestudies was evaluated by the modified Newcastle-Ottawa scale.The data was extracted by the Review Manager5.30.Results A total of19articles were brought into this Meta-analysis.The outcomes were divided into primaryoutcomes and secondary outcomes.Excerpt for the short-term VAS score was lower in PELD group(P=0.010),otherindex,including long-term VAS score(P=0.120),ODI score(P=0.260),complication(P=0.100)and recurrence(P=0.100),didn’t had significant difference in two groups.The blood loss(P=0.000),hospital stay(P=0.000)and the length of incision(P=0.000)were all superiority in PELD group.Whereas the operative time was shorter in MED group(P=0.001).Conclusion PELD was a more minimally invasive and secure technique in lumbar discherniation.

关 键 词：META分析 腰椎间盘突出 椎间盘镜 椎间孔镜 主要方法 次要方法 

分 类 号：R681.53[医药卫生—骨科学]