经皮椎间孔镜下与椎板间开窗椎间盘切除术治疗腰椎间盘突出症的Meta分析

发布时间：2019-07-13 16:53

【摘要】：[目的]对经皮椎间孔镜下椎间盘切除术(percutaneous transforaminal endoscopic discectomy,PTED)与椎板间开窗椎间盘切除术治疗腰椎间盘突出症(LDH)的疗效进行系统评价。[方法]计算机检索建库至2016年4月Cochrane Library、Pub Med、Medline、Academic Search Premier、中国生物医学文献数据库、中国知网、维普和万方数据库文献,同时手工检索辅助,收集关于PTED和椎板间开窗椎间盘切除术治疗LDH的随机对照试验。根据纳入与排除标准进行文献筛选、质量评价和数据提取后,应用Revman 5.3软件对各项指标进行Meta分析。[结果]最终纳入10篇文献708例观察对象,其中PTED组349例,椎板间开窗组359例。分析结果显示,PTED组与椎板间开窗组在手术时间、术后疗效评分及优良率方面差异无统计学意义,而在切口长度、出血量、术后卧床时间及住院时间方面PTED组结果更优,差异具有统计学意义。[结论]PTED治疗腰椎间盘突出症与椎板间开窗术效果相当,但PTED具有出血少、创伤小及恢复快等优势。不过因受限于纳入研究的数量和质量,上述结论仍需更多高质量长期随访的随机对照试验进一步验证。
[Abstract]:[objective] to evaluate the efficacy of percutaneous intervertebral disc resection (percutaneous transforaminal endoscopic discectomy,PTED) and interlaminar fenestration in the treatment of lumbar disc protrusion (LDH). [methods] from April 2016 to April 2016, Cochrane Library,Pub Med,Medline,Academic Search Premier, Chinese Biomedical Literature Database, China knowledge Network, Weipu and Wanfang databases were searched by computer, and a randomized controlled trial of PTED and interlaminar fenestration for LDH was collected. According to the inclusion and exclusion criteria, the literature was screened, the quality evaluation and data extraction were carried out, and the Meta analysis of the indexes was carried out by using Revman 5.3 software. [results] 708 cases of 10 articles were included, including 349 cases in PTED group and 359 cases in interlaminar fenestration group. The results showed that there was no significant difference in operation time, postoperative curative effect score and excellent and good rate between PTED group and lamina fenestration group, but the results in PTED group were better in incision length, bleeding volume, postoperative bed rest time and hospitalization time. [conclusion] the effect of PTED in the treatment of lumbar disc protrusion is the same as that of interlaminar fenestration, but PTED has the advantages of less bleeding, less trauma and faster recovery. However, due to the limited quantity and quality of the study, the above conclusions still need to be further verified by more high-quality long-term follow-up randomized controlled trials.
【作者单位】：滨州医学院附属医院;
【分类号】：R687.3

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