MED与OLD治疗腰椎间盘突出症的Meta分析

发布时间：2018-03-15 02:19

本文选题：腰椎间盘突出症　切入点：后路显微椎间盘镜　出处：《石河子大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:利用Meta分析方法系统评价后路显微椎间盘镜腰椎间盘髓核摘除术(Microendoscopic Discectomy,MED)与传统开窗腰椎间盘髓核摘除术(Open Lumbar Discectomy,OLD)治疗腰椎间盘突出症(Lumbar Disc Herniation,LDH)的临床疗效和安全性。方法:采用系统评价方法,计算机检索Pub Med、Cochrane Library、EMBASE、MEDLINE、相关期刊论文、中国生物医学文献数据库、万方数据库(1997年01月-2014年09月),手工检索相关期刊。搜集应用后路显微椎间盘镜腰椎间盘髓核摘除术和传统开窗腰椎间盘髓核摘除术治疗成人单节段腰椎间盘突出症的随机对照研究。2位作者独立评估各研究的质量,将各研究中的手术后疗效、手术时间、术中失血量、住院时间等数据提取整理为电子基线表,并将这些研究的数据通过Rev Man 5.2软件进行Meta分析与综合。结果:共17篇研究符合纳入标准,共计2551例样本被纳入分析研究。Meta分析结果显示:与传统开窗腰椎间盘髓核摘除术相比,后路显微椎间盘镜腰椎间盘髓核摘除术在术后疗效(OR=1.22,95%CI:0.44~3.42,P=0.70)和手术时间(MD=2.22,95%CI:-2.37~6.80,P=0.34)方面差异无统计学意义;在术中出血量(MD=-81.24,95%CI:-111.00~-51.49,P0.01)、手术切口长度(MD=-2.88,95%CI:-4.09~-1.68,P0.01)、住院时间(MD=-3.67,95%CI:-5.44~-1.90,P0.01)、恢复日常生活时间(MD=-19.11,95%CI:-26.09~-12.13,P0.01)和术后卧床时间(MD=-9.09,95%CI:-13.28~-4.91,P0.01)方面差异有统计学意义。结论:后路显微椎间盘镜腰椎间盘髓核摘除术与传统开窗腰椎间盘髓核摘除术治疗单节段腰椎间盘突出症,术后疗效和手术操作时间相当;但后路显微椎间盘镜腰椎间盘髓核摘除术具有术中出血量少、手术切口小、住院时间、恢复日常生活时间及术后卧床时间短等优点。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of microendoscopic discectomytomy (MED) and open Lumbar discectomy (OLDH) in the treatment of Lumbar Disc herniation of lumbar intervertebral disc herniation by Meta analysis. Methods: a systematic evaluation method was adopted, Computer search for Pub Medsite Cochrane Library EMBASE MEDLINE, full text Database of Chinese Journals, Chinese Biomedical Literature Database, Wanfang database (January 1997-September 2014), manual retrieval of relevant journals. Collection and application of posterior microdiscectomy and traditional fenestration for the treatment of single segment lumbar intervertebral disc process in adults. A randomized controlled study of 2. 2 authors independently assessed the quality of each study. The data of post-operative effect, operation time, blood loss during operation and hospital stay were extracted and sorted into an electronic baseline table. The data of these studies were analyzed and synthesized by Meta through Rev Man 5.2 software. Results: a total of 17 studies met the inclusion criteria. A total of 2551 samples were included in the study. Meta-analysis showed that compared with traditional fenestration of lumbar disc nucleus pulposus, There was no significant difference in the curative effect of posterior microdiscectomy for lumbar disc nucleus pulposus (1.2295% CI: 0.443.42% P0.70) and the time of operation (MD2.2295% CI-2.376.80% P0.34). The volume of intraoperative bleeding was MD-81.2495 CI-111.00 ~ -51.49% P0.01, the length of incision MD-2.895% CI-4.09 -1.68% P0.01, the length of hospitalization MD-3.695% CI-5.44-1.90 P0.01, the time of daily life recovery MD-19.1195CI-26.099-12.13P0.01) and the postoperative bed time MD-9.095 CI-13.28 ~ -4.91% P0.01.Conclusion: posterior discectomy has statistical significance compared with traditional discectomy. Fenestration of nucleus pulposus in the treatment of single segment protrusion of lumbar intervertebral disc, The curative effect was the same as the operative time, but the posterior microdiscectomy had the advantages of less blood loss, small incision, hospital stay, recovery time of daily life and short time of bed rest after operation.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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