单侧双通道内镜手术治疗腰椎管狭窄症安全性的Meta分析  

Safety of unilateral biportal endoscopic discectomy and microendoscopic discectomy for lumbar spinal stenosis:a Meta-analysis

作　　者：肖亚杰 申杨勇[1] 陈京峰[1] 崇辉[1] XIAO Ya-jie;SHEN Yang-yong;CHEN Jing-feng;CHONG Hui(Department of Orthopedics,Xiyuan Hospital of China Academy of Chinese,Beijig 100091,China)

机构地区：[1]中国中医科学院西苑医院骨科,北京100091

出　　处：《中国临床神经外科杂志》2022年第2期85-89,共5页Chinese Journal of Clinical Neurosurgery

摘　　要：目的系统分析单侧双通道内镜手术(UBE)与显微镜下椎管减压术(MED)治疗腰椎管狭窄症的安全性。方法计算机检索Pubmed、Cochrane library、MEDLINE、Web of Science、Embase等英文数据库,以及中国知网和万方中文数据库。纳入UBE和MED治疗腰椎管狭窄症的临床随机对照试验(RCT)及队列研究。观察指标包括总并发症发生率,以及硬膜外血肿、神经根损伤、硬膜囊损伤、减压不彻底、因相关并发症再次手术发生率。采用Revman 5.3软件进行Meta分析。结果最终纳入7篇相关研究,包括2篇RCT、5篇队列研究;共纳入475例病人,其中UBE有248例,MED有227例。Meta分析显示两种手术方法的总并发症发生率以及硬膜外血肿、神经根损伤、硬膜囊损伤、减压不彻底、因相关并发症再次手术等并发症发生率均无统计学差异(P>0.05)。结论 UBE与MED治疗腰椎管狭窄症在安全性方面基本一致。Objective To systematically analyze the incidence of complications related to unilateral biportal endoscopic discectomy(UBE) and microendoscopic discectomy(MED) for the patients with lumbar spinal stenosis.Methods The English databases including Pubmed,Cochrane library,MEDLINE,Web of Science and Embase,and Chinese databases including CNKI and Wanfang were searched for randomized controlled trials(RCTs) and cohort studies of UBE and MED in the treatment of lumbar spinal stenosis.Observational parameters included the total incidence of complications,and the incidence of epidural hematoma,nerve root injury,dural sac injury,incomplete decompression,and reoperation due to related complications.Meta-analysis was performed using Revman 5.3 software.Results Seven studies were finally included,including 2 RCTs and 5 cohort studies.A total of 475 patients were included,including 248 patients with UBE and 227 patients with MED.Meta-analysis showed that there were no significant differences in the total complication rates,and the rates of epidural hematoma,nerve root injury,dural sac injury,incomplete decompression and reoperation due to related complications of the two surgical methods(P>0.05).Conclusions There is no statistical difference in the safety of UBE and MED in the treatment of lumbar spinal stenosis.

关 键 词：腰椎管狭窄症 单侧双通道内镜手术 显微镜下椎管减压术 并发症 META分析 

分 类 号：R681.15[医药卫生—骨科学] R651.11[医药卫生—外科学]