内镜治疗对比开放手术治疗腕管综合征的meta分析

发布时间：2018-08-04 19:35

【摘要】：目的通过meta分析，对内镜下腕管松解术(endoscopic carpal tunnel release，ECTR)和常规腕管开放手术（open carpal tunnel release，OCTR）治疗腕管综合征（carpal tunnel syndrome，CTS）的术后疗效进行比较，比较两种术式的优劣。方法对MEDLINE、Cochrane图书馆、CNKI数据库、万方数据库及相关会议进行检索，收集1989年~2014年的所有相关的随机对照试验，按制定纳入标准及排除标准筛选文献，利用Revman5.0软件对相关数据进行meta分析。结果总共纳入22篇相关文献，包括手术1962例，其中内镜治疗组930例，开放手术治疗组1032例。Meta分析结果表明，ECTR组与OCTR组在手术时间（MD=1.96；95%CI [-0.25，4.18]，P=0.08）、术后缓解率（MD=0.87；95%CI [0.55，1.39]，P=0.57）、术后并发症发生率(MD=0.67；95%CI [0.42，1.05]，P=0.08)以及术后患者满意度(MD=1.58；95%CI [0.96，2.60]，，P=0.07)方面，均无明显统计学差异（P＞0.05）；ECTR组在术后捏力（MD=0.77；95%CI [0.13，1.41]，P=0.02）与握力（MD=5.25；95%CI [0.03，10.48]，P=0.05）方面，均优于OCTR组（P＜0.05）。结论ECTR组在术后捏力与握力方面优于OCTR组，而在手术时间、术后缓解率、术后并发症发病率以及术后患者满意度上，两种术式并无明显差异。
[Abstract]:Objective to compare the postoperative efficacy of endoscopic carpal tunnel release (endoscopic carpal tunnel release) and conventional open carpal tunnel operation (open carpal tunnel release) in the treatment of carpal tunnel syndrome (carpal tunnel syndromes) by meta analysis, and compare the advantages and disadvantages of the two methods. Methods the CNKI database, Wanfang database and related conferences were searched by MEDLINE Cochrane Library. All the relevant randomized controlled trials from 1989 to 2014 were collected, and the literature was screened according to the inclusion criteria and exclusion criteria. Revman5.0 software is used to analyze the related data by meta. Results A total of 22 related literatures were included, including 1962 cases of operation, including 930 cases in endoscopic therapy group and 1032 cases in open operation group. The results showed that the operative time (MD1.96 ~ 95CI [-0.254.18]) and the postoperative remission rate (MD0.87) were found in the two groups (MD1.96 ~ 95CI [-0.254.18]). There were no significant differences in postoperative pinch strength (MD0.7795CI [0.131.41]) and postoperative grip strength (MD5.2595CI [0.0310.48] P0. 05) in 95%CI group (P > 0. 05), the incidence of postoperative complications (MDT 0.67% 95 CI [0. 42 卤1. 05] P0. 08) and postoperative patient satisfaction (MD1. 5895 CI [0. 96 卤2. 60] P0. 07) were better than those in OCTR group (P < 0. 05). Conclusion the postoperative pinch strength and grip strength in ECTR group were better than those in OCTR group, but there was no significant difference in operation time, postoperative remission rate, incidence of postoperative complications and postoperative patient satisfaction.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R688

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