[1]吕浩源 肖强兵△ 张艳佶 陈旻星 朱天娇 宋虎.PTED与FD治疗腰椎间盘突出症的Meta分析[J].中国中医骨伤科杂志,2017,25(06):23-28.
 L Haoyuan XIAO Qiangbing ZHANG Yanji CHEN Minxing ZHU Tianjiao SONG Hu.Meta Analysis of PTED Versus FD in Treatment of Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(06):23-28.
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PTED与FD治疗腰椎间盘突出症的Meta分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年06期
页码:
23-28
栏目:
临床研究
出版日期:
2017-07-08

文章信息/Info

Title:
Meta Analysis of PTED Versus FD in Treatment of Lumbar Disc Herniation
文章编号:
1005-0205(2017)06-0023-06
作者:
吕浩源1 肖强兵12△ 张艳佶1 陈旻星1 朱天娇1 宋虎1
1.湖北中医药大学(武汉,430065)
2.湖北省中医院
△.通信作者 E-mail:18971368910@163.com
Author(s):
LÜ Haoyuan1 XIAO Qiangbing12△ ZHANG Yanji1 CHEN Minxing1 ZHU Tianjiao1 SONG Hu1
1.Hubei University of Chinese Medicine, Wuhan 430065,China;
2.Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan 430074,China.
关键词:
腰椎间盘突出症 经皮椎间孔镜椎间盘切除术 腰椎后路椎板开放减压腰椎间盘切除术 Meta分析
Keywords:
lumbar disc herniation percutaneous transfouraminal endoscope discectomy fenestration discectomy Meta analysis
分类号:
R681.5
文献标志码:
A
摘要:
目的:通过Meta分析比较经皮椎间孔镜椎间盘切除术(PTED)与后路开放减压腰椎间盘切除术(FD)治疗腰椎间盘突出症的手术指标及疗效。方法:计算机检索Pubmed,EMbase,Cochrane Library,中国生物医学文献数据库(CBM),中国期刊全文数据库(CNKI)以及万方数据知识服务平台(WANFANG),维普中文科技期刊数据库(VIP)等权威数据库,手工检索相关杂志,用NOS量表(The Newcastle-Ottawa Scale)进行评分,按照标准纳入随机对照试验,采用Cochrane协作网提供的RevMan5.3软件进行数据分析。结果:共纳入21篇论文,1 564例患者,其中PTED组839例,FD组 725例。PTED在出血量、切口长度以及卧床时间上具有明显的优势,但FD作为传统经典的术式,可缩短手术时间。另外,在疗效评估方面,FD和PTED的VAS指数并没有明显差异,但PTED远期ODI指数较FD好,可认为最终疗效方面PTED具有一定优势。结论:PTED与FD均为目前流行的术式,但有不同特点,临床可根据具体情况进行选择。
Abstract:
Objective: To compare the efficacy of percutaneous transforaminal endoscopic discectomy(PTED)versus fenestration discectomy(FD)in the treatment of Lumbar disc herniation(LDH). Methods: The randomized controlled trials(RCT)for comparing PTED and FD in the treatment of LDH were retrieved from MEDLINE, EMbase, Pubmed,Cochranc library, CBM,CNKI,WANFANG and VIP databases by computer. The related orthopedic documents were collected by manual retrieval, all the dates is rated by NOS Scale(The Newcastle-Ottawa Scale),the RevMan5.3 statistical software(supplied by Cochrane collaboration)was used for conducting the meta analysis. Results: Twenty-one RCTS are included, involving 1564 patients, in which 839 cases are treated with PTED and 725 cases with FD. To compare the two surgical methods, PTED has the obvious advantages on Hospital stay, Blood loss, Incision length and bedridden time, but as a classic surgical method, FD can shorten the operation time. In terms of efficacy evaluation, the VAS indexes of FD and PTED show no difference, but long-term ODI index of FD is better than that of PTED. It's thought that PTED having better final efficacy than FD. Conclusion: Both PTED and FD are the most popular surgical methods, but they have different characteristics, which can be chose in clinic according to the specific situation.

参考文献/References:

[1] Hussein M.Minimal incision,multifidus-sparing microendoscopic diskectomy versus conventional microdiskectomy for highly migrated intracanal lumbar disk herniations[J].J Am Acad Orthop Surg,2016,24(11):805-813.
[2] Wankhade UG,Umashankar MK,Reddy BS.Functional outcome of lumbar discectomy by fenestration technique in lumbar disc prolapse - return to work and relief of pain[J].J Clin Diagn Res,2016,10(3):9-13.
[3] 王银,陈根元,胡龙,等.开放与微创经椎间孔椎体间融合治疗单节段退行性腰椎疾病的Meta分析[J].中国组织工程研究,2013,17(13):2415-2422.
[4] 丁文彬,郑召民,王建儒,等.微创与开放经椎间孔椎体间融合术治疗单节段腰椎病变的Meta分析[J].中国脊柱脊髓杂志,2015,25(1):45-53.
[5] Zhang BF,Ge CY,Zheng BL,et al.Transforaminal lumbar interbody fusion versus posterolateral fusion in degenerative lumbar spondylosis:a meta-analysis[J].Medicine(Baltimore),2016,95(40):e4995.
[6] Wang K,Hong X,Zhou BY,et al.Evaluation of transforaminal endoscopic lumbar discectomy in the treatment of lumbar disc herniation[J].Int Orthop,2015,39(8):1599-1604.
[7] Kim MJ,Kim SJ,Park SC,et al.Adjuvant radiotherapy for the treatment of stage IV rectal cancer after curative resection:A propensity score-matched analysis and meta-analysis[J].Medicine(Baltimore),2016,95(47):e4925.
[8] 崔维,林欣.经皮椎间孔镜与开放性手术治疗腰椎间盘突出症的疗效对比[J].中国临床医生,2014,42(4):60-62.
[9] 巩陈,呼国臣,申才良.椎间孔镜神经根减压松解术与椎板间开窗髓核摘除术治疗单节段单侧腰椎间盘突出症对比观察[J].山东医药,2016,56(27):87-89.
[10] 韩康,高浩然,卞娜,等.经皮椎间孔镜与单纯椎板开窗术治疗腰椎间盘突出症临床疗效比较[J].中华全科医学,2015,13(6):868-871.
[11] Pan Z,Ha Y,Yi S,et al,Efficacy of Transforaminal Endoscopic Spine System(TESSYS)Technique in Treating Lumbar Disc Herniation[J].Med Sci Monit,2016,22:530-539.
[12] 苏建成,包杰.经皮椎间孔镜与椎板开窗治疗复发性腰椎间盘突出症的临床疗效分析[J].实用骨科杂志,2016,22(3):261-264.
[13] 石裕明,王荣生,何立文.对比分析椎间孔镜术与传统椎间板开窗术治疗中青年腰椎间盘突出症的临床疗效[J].临床医学,2016,36(9):33-35.
[14] 禤天航,刘效仿,曹正霖,等.经皮椎间孔镜与椎板开窗髓核摘除术治疗复发性腰椎间盘突出症的疗效比较[J].中国骨与关节损伤杂志,2016,31(9):972-974.
[15] 张勇,逯春洁,史福东,等.侧路椎间孔镜髓核摘除术与传统手术方法治疗腰椎间盘突出症的效果比较[J].现代中西医结合杂志,2016,25(1):87-89.
[16] 陶志强,吴庭胜,范少勇,等.椎间孔镜与开放术治疗腰椎间盘突出症的疗效分析[J].江西医药,2016,51(1):32-34.
[17] 刘俊良,镇万新,高国勇,等.椎间孔镜与椎板开窗治疗腰椎间盘突出症的前瞻性对照研究[J].中国骨与关节杂志,2014,3(4):245-250.
[18] Li J,Ma C,Li Y,et al.A comparison of results between percutaneous transforaminal endoscopic discectomy and fenestration discectomy for lumbar disc herniation in the adolscents[J].Chin Med J,2015,95(47):3852-3855.
[19] 王诗成,潘磊,黄必留,等.椎间孔镜和小切口手术治疗腰椎间盘突出症的比较[J].实用骨科杂志,2015,21(4):293-296.
[20] 任佳彬,刘鹏飞,孙兆忠,等.椎间孔镜术与传统椎板间开窗术治疗青少年腰椎间盘突出症的比较研究[J].中国矫形外科杂志,2015,23(21):1938-1942.
[21] 王建顺,张军,王新虎,等.经皮椎间孔镜与小开窗髓核摘除术治疗腰椎间盘突出症的疗效比较[J].颈腰痛杂志,2016,37(4):300-302.
[22] 丁伟国,徐卫星,卢笛,等.经皮椎间孔镜与开放椎板间开窗术治疗腰椎间盘突出症的疗效分析[J].中国内镜杂志,2016,22(4):43-48.
[23] 赵采花,汤逊.经皮椎间孔镜与椎板开窗术治疗腰椎间盘突出症的疗效对比[J].中国疼痛医学杂志,2014,20(1):60-63.
[24] 赵锡武,韩康,刘鑫,等.经皮椎间孔镜与椎板开窗髓核摘除术治疗腰椎间盘突出症的临床疗效比较[J].现代生物医学进展,2015,15(14):2692-2695.
[25] 武胜.经皮椎间孔镜与椎板间开窗术治疗腰椎间盘突出症的中期临床疗效分析[D].成都:成都中医药大学,2014.
[26] 周江山.经皮椎间孔镜与椎板间开窗术治疗腰椎间盘突出症的疗效对比研究[D].乌鲁木齐:新疆医科大学,2015.
[27] 李世伟.经皮椎间孔镜与椎板间开窗术治疗腰椎间盘突出症的近期疗效对比分析[D].成都:成都中医药大学,2013.
[28] 刘玉国.腰椎间盘突出症经椎间孔镜治疗和椎板间开窗治疗的疗效观察[D].济南:山东中医药大学,2015.
[29] Higgins JPT,Greens S.Cochrane handbook for systematic reviews of interventions version 5.1[update March 2011][EB/OL].(2011-03-21)
[2015-01-02].http://handbook.cochrane.org.
[30] 黄民主.临床流行病学[M].北京:高等教育出版社,2008:33.

更新日期/Last Update: 2017-06-15