全内镜技术与显微内镜技术治疗单节段腰椎管狭窄症的Meta分析  

Full-endoscopic technique versus micro-endoscopic technique in treating single segment lumbar spinal stenosis:a meta analysis

作　　者：贾忠雄 唐敏 胡侦明[1] 张晓军[1] 江维[1] 沈皆亮[1] 周年[1] 郝杰[1] JIA Zhongxiong;TANG Min;HU Zhenming;ZHANG Xiaojun;JIANG Wei;SHEN Jieliang;ZHOU Nian;HAO Jie(Department of Orthopedics,First Affiliated Hospital,Chongqing Medical University,Chongqing 400016,China;Department of Oncology,First Affiliated Hospital,Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院骨科,400016 [2]重庆医科大学附属第一医院肿瘤科,400016

出　　处：《重庆医学》2021年第9期1568-1572,共5页Chongqing medicine

摘　　要：目的系统评价全内镜技术与显微内镜技术治疗腰椎管狭窄症的临床疗效与安全性。方法计算机检索中国知网、万方数据、中国生物医学数据库、PubMed、Embase和Cochrane图书馆,收集有关全内镜技术与显微内镜技术治疗腰椎管狭窄症的研究,检索时限均为建库至2020年4月。采用纽卡索-渥太华量表(NOS)进行文献质量评估,运用Review Manager 5.3软件对提取的有效数据进行Meta分析。结果共纳入4项随机对照研究,2项回顾性对照研究,1项病例对照研究。本Meta分析结果显示,全内镜技术与显微内镜技术两种手术方式的手术时间、术后腰部视觉模拟评分(VAS)、术后腰部功能障碍指数(ODI)、手术后翻修率、手术优良率比较,差异无统计学意义(P>0.05);住院时间和术后下肢VAS比较,差异有统计学意义(P<0.05),全内镜技术的住院时间短于显微内镜技术,术后腿部VAS评分低于显微内镜技术。结论全内镜技术与显微内镜技术治疗腰椎管狭窄症均能获得良好的手术效果,但全内镜技术的住院时间短,下肢疼痛症状改善优于显微内镜技术。Objective To systematically evaluate the efficacy and safety of full-endoscopic technique and micro-endoscopic technique for treating single segment lumbar spinal stenosis.Methods The databases of CNKI,Wanfang Data,CBM,PubMed,EMBASE and Cochrane Library were retrieved by computer to collect the studies on full-endoscopic technique and micro-endoscopic technique for treating lumbar spinal stenosis.The retrieval time was from the database establishment to April 2020.The quality of included literatures was assessed by using the Newcastle-Ottawa Scale(NOS).The extracted effective data conducted the meta analysis by using Review Manager 5.3 software.Results A total of 4 randomized controlled trials,2 retrospective control trials and 1 case-control study were included into this study.The results indicated that there were no statistically significant differences in the operation time,postoperative visual analogue scale(VAS)score of lumbar region,postoperative Oswestry disability index(ODI),revision rate after operation and excellent and good rate of operation between the full-endoscopic technique and micro-endoscopic technique(P>0.05).The differences in the duration of hospital stay and postoperative VAS score of lower limbs were statistically significant(P<0.05).The duration of hospital stay of the full-endoscopic technique was shorter than that of the micro-endoscopic technique,and the postoperative VAS score of the lower limbs was lower than that of the micro-endoscopic technique.Conclusion The full-endoscopic technique and micro-endoscopic technique have the good clinical efficacy in treating the lumbar spinal stenosis,but the full-endoscopic technique has shorter duration of hospital stay and the improvement of lower limb pain symptoms is superior to the micro-endoscopic technique.

关 键 词：脊柱内镜 椎间孔镜 显微内镜 腰椎管狭窄症 临床疗效 

分 类 号：R687.3[医药卫生—骨科学]