单双侧经皮椎体成形术治疗骨质疏松性椎体压缩骨折的Meta分析

发布时间：2018-07-26 14:45

【摘要】：目的:用Meta分析的方法对单双侧经皮椎体成形术(Percutaneous Vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(Osteoporotic vertebral compression fractures,OVCF)的临床疗效进行对比分析。方法:数据库检索1987年1月至2016年12月,包括PubMed,Springer,EMBASE,OVID,Web of science,Cochrane central register of controlled trial,CNKI,万方数据库。手工检索《Spine》,《Euro Spine》,《中华骨科杂志》,《中国脊柱脊髓》等杂志。按纳入和排除标准收集文献,进行异质性评价和偏倚评价,用Review Manager 5.3进行数据分析。结果:亚组分析和汇总显示VAS评分在术后3月时,双侧椎弓根组评分低于单侧组(Z=2.47,P=0.01)。在其他亚组没有明显统计学差异。汇总后分析显示双侧组评分低于单侧组(Z=2.93,P=0.003)。骨质疏松症患者生活评分(QUALEFFO)在术后3月,6月,12月均有显著差异,双侧椎弓根组评分低于单侧组(Z=5.81,P0.00001)。单双侧组术后Oswestry功能障碍指数评分没有明显统计学差异(Z=0.45,P=0.65)。双侧组在手术时间及骨水泥注入量上明显超过单侧组(P0.00001),两组间的骨水泥渗漏率间的比较却没有统计学的差异(P=0.65)。结论:单侧组能缩短手术时间,减少骨水泥注入量,在术后即刻疼痛缓解上和功能活动上能获得满意效果,但随着随访时间的延长,双侧椎弓根组在疼痛缓解和生活质量上优于单侧组。
[Abstract]:Objective: to compare the clinical efficacy of Percutaneous Vertebroplasty (Percutaneous Vertebroplasty) in the treatment of osteoporotic vertebral compression fracture (Osteoporotic vertebral compression fracture) by Meta. Methods: the database was searched from January 1987 to December 2016. Manual search < Spine >, < Euro Spine >, Chinese Journal of Orthopaedics, Chinese Spine and Spinal Cord, et al. Literature was collected according to inclusion and exclusion criteria, heterogeneity and bias were evaluated, and data were analyzed with Review Manager 5.3. Results: the subgroup analysis and summary showed that the score of VAS in bilateral pedicle group was lower than that in unilateral group at 3 months after operation. There was no significant difference in other subgroups. The score of bilateral group was lower than that of unilateral group (ZT2.93 P0. 003). The (QUALEFFO) scores of osteoporosis patients were significantly different in 3 months, 6 months and 12 months after operation, and the scores in bilateral pedicle group were lower than those in unilateral group (P 0.00001). There was no significant difference in the score of Oswestry dysfunction index between the unilateral and bilateral groups (P < 0. 65). The time of operation and the amount of bone cement injection in bilateral group were significantly higher than that in unilateral group (P0.00001), but there was no statistical difference between the two groups in the rate of bone cement leakage (P0. 65). Conclusion: unilateral group can shorten the operation time, reduce the amount of bone cement injection, and obtain satisfactory results in immediate pain relief and functional activity after operation, but with the extension of follow-up time. Bilateral pedicle group was superior to unilateral group in pain relief and quality of life.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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