[1]唐谨 李莹 吴从俊 刘鏐 张同会 鲁齐林 陈思 李俊杰.经皮椎间孔镜与椎间盘镜下手术治疗腰椎间盘突出症效果比较的Meta分析[J].中国中医骨伤科杂志,2019,27(03):23-28.
　TANG Jin LI Ying WU Congjun LIU Liu ZHANG Tonghui LU Qilin CHEN Si LI Junjie.A Meta-Analysis of Percutaneous Endoscopic Lumbar Discectomy Versus Micro Endoscopic Discectomy for Treatment of Lumbar Disc Herniation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(03):23-28.
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经皮椎间孔镜与椎间盘镜下手术治疗腰椎间盘突出症效果比较的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27卷
期数:
2019年03期
页码:
23-28
栏目:
文献研究
出版日期:
2019-02-28

文章信息/Info

Title:
A Meta-Analysis of Percutaneous Endoscopic Lumbar Discectomy Versus Micro Endoscopic Discectomy for Treatment of Lumbar Disc Herniation
文章编号:
1005-0205(2019)03-0023-06
作者:
唐谨1 李莹1 吴从俊1 刘鏐1 张同会1 鲁齐林1 陈思1 李俊杰1
1湖北六七二中西医结合骨科医院(武汉,430079)
Author(s):
TANG Jin1 LI Ying1 WU Congjun1 LIU Liu1 ZHANG Tonghui1 LU Qilin1 CHEN Si1 LI Junjie1
1Hubei 672 Orthopaedics Hospital of Integrated Chinese Western Medicine,Wuhan 430079,China.
关键词:
经皮椎间孔镜;  椎间盘镜;  腰椎间盘突出症;  随机对照试验;  Meta 分析
Keywords:
percutaneous endoscopic lumbar discectomy(PELD);  micro endoscopy discectomy(MED);  lumbar disc herniation(LDH);  randomized controlled trial;  Meta-analysis
分类号:
R681.5
文献标志码:
A
摘要:
目的:系统分析并比较经皮椎间孔镜手术(PELD)与椎间盘镜手术(MED)治疗腰椎间盘突出症的效果。方法:计算机检索中国期刊全文数据库(CNKI)、中国生物医学数据库(CBM)、万方、维普期刊网、the Cochrane Central Register of Controlled Trials(CEN-TRAL),PubMed,EMbase,Elsevier数据库,检索国内外公开发表的治疗单阶段腰椎间盘突出症的中/英文文献,检索时间均为建库至2016年8月20日,收集关于PELD和 MED治疗腰椎间盘突出症的随机对照试验。根据纳入与排除标准独立进行文献检索、质量评价和资料提取后,应用Rev-Man 5.2软件进行Meta 分析。结果:最终纳入4篇文献,共379例受试者,其中男218例,女161例; PELD组202例,MED组177例。Meta分析结果显示:与MED组相比,PELD组术中出血量少(MD=-59.00,95%CI(-88.07,-29.92),P<0.00 001),术后下地时间早(MD=-5.02,95%CI(-5.20,-4.83),P<0.000 01),手术时间长(MD=16.99,95%CI(5.99,27.99),P<0.000 01),差异有统计学意义; 术后VSA评分(SMD=0.04,95%CI(-0.20,0.28),P=0.76)及JOA评分(SMD=0.20,95%CI(-0.12,0.52),P=0.22)两组比较差异无统计学意义。结论:PELD和MED都是腰椎间盘突出症的有效治疗方式,PELD较MED对组织损伤更小,出血量更少,术后恢复更快,更具有微创优势,但其学习曲线更长。
Abstract:
Objective:To systematically compare and evaluate the effectiveness between percutaneous endoscopic lumbar discectomy and micro endoscopic discectomy in treatment of lumbar disc herniation.Methods:Cochrane Library,Pub Med,PubMed,EMbase,Elsevier,the China Biological Medicine Database,CNKI,VIP and Wanfang Database were searched for articles published from the building of data base up to August 20,2016.Randomized controlled trials of percutaneous endoscopic lumbar discectomy and micro endoscopy discectomy in treatment of lumbar disc herniation were collected. The eligible trials were extracted according to the inclusion and exclusion criteria. The Rev-Man 5.2 software was used for data analysis.Results:A total of 4 RCTs involving 379 patients were included,218 cases in male and 161 cases in female,202 PELD cases and 177 MED cases were enrolled. The results of Meta-analysis showed that when compared with MED,PELD entailed less intra-operative blood loss(MD=-59.00,95%CI(-88.07,-29.92),P<0.000 01),earlier walk time after operation(MD=-5.02,95%CI(-5.20,-4.83),P<0.000 01),longer operation time(MD=16.99,95%CI(5.99,27.99),P<0.000 01),there were significant sifferences and there were no significant differences in VAS(SMD=0.04,95%CI(-0.20,0.28),P=0.76)and JOA(SMD=0.20,95%CI(-0.12,0.52),P=0.22)after operation.Conclusion:The Meta-analysis shows that PELD and MED are both effective in treating lumbar disc herniation.PELD has less injury,less intra-operative blood loss,faster postoperative recovery,more minimally invasive,but longer learning curve.

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更新日期/Last Update: 2019-02-28