PLIF与TLIF治疗成人腰椎滑脱症疗效对比的Meta分析

发布时间：2018-06-30 09:56

本文选题：meta分析 + 腰椎融合　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:均有大量文献报道PLIF和TLIF两种方法治疗成人腰椎滑脱症获得了满意的疗效,但哪种方法更具优势尚缺乏文献报道。收集文献资料,采用Meta分析的方法对比研究PLIF和TLIF两种方法治疗成人腰椎滑脱症的疗效,为临床决策提供证据。方法:在PUBMED、MEDLINE、CNKI及Cochrane Collaboration Library数据库中检索自1950年至2015年2月的随机对照试验(RCTs,relevant randomized controlled trials)和观察对照研究。按照纳入排除标准对文献进行筛选,对研究涉及的主要结局指标文献中应有详细的数据结果。按照Grade指南对文献中的证据进行质量评估。结果:经检索没有符合标准的随机对照试验,最后共纳入5篇对照研究文献。PLIF组和TLIF组在临床满意度中无显著性差异(OR=0.94;95%CI=0.54-1.61;P=0.81)。PLIF组和TILF组的满意率分别为83.0%和83.9%。在PLIF组和TLIF组之间,手术并发症发生率存无显著性差异(OR=4.67;95%CI=0.46-47.63;P=0.10)。并发症的发生率在两组中分别为8.29%和2.73%。PLIF组和TLIF组的融合率分别为98.3%和98.4%。两组间的融合率无统计学差异(OR=1.15;95%CI=0.21-6.20;P=0.87)。来自其中两个研究的融合率两组均为100%,另外两个研究中PLIF组和TLIF组的融合率分别为91.7%和96.7%。结论:PLIF和TLIF在治疗成人腰椎滑脱症中的临床满意度、围手术期并发症发生率、融合率均无统计学差异,两种方法均能较好地缓解患者腰痛、腿疼、间歇性跛行等症状,可以认为PLIF和TLIF对于成人腰椎滑脱症的治疗具有相同的优势。但本次meta分析纳入文献较少、纳入病例数较少,证据质量等级较低,对这一结果应谨慎解读。
[Abstract]:Objective: both PLIF and TLIF have been reported to be effective in the treatment of adult lumbar spondylolisthesis. To compare the efficacy of PLIF and TLIF in the treatment of adult lumbar spondylolisthesis by Meta-analysis. Methods: random controlled trials (RCTs) and observational controlled trials (RCTs) were searched in PUBMED MEDLINEN CNKI and Cochrane collaboration Library database from 1950 to February 2015. According to the exclusion criteria, the literature should be screened, and detailed data should be obtained in the literature on the main outcome indicators involved in the study. Evaluate the quality of the evidence in the literature in accordance with Grade guidelines. Results: there was no significant difference in clinical satisfaction between PLIF group and TLIF group after searching for no randomized controlled trial according to the standard. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. There was no significant difference in the incidence of surgical complications between PLIF group and TLIF group (OR4.6795 CI 0.46-47.63P0.10). The incidence of complications was 8.29% in both groups and 98.3% in PLIF group and 98.4% in TLIF group. There was no significant difference in the fusion rate between the two groups. The fusion rates were 91.7% in PLIF group and 96.7% in TLIF group, respectively. Conclusion there is no significant difference in clinical satisfaction, perioperative complications and fusion rate between the two groups in the treatment of adult lumbar spondylolisthesis. The two methods can relieve the symptoms of low back pain, leg pain and intermittent claudication. PLIF and TLIF have the same advantages in the treatment of adult lumbar spondylolisthesis. However, the meta analysis included less literature, fewer cases and lower quality of evidence, which should be interpreted carefully.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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