摘要
目的 系统评价椎间盘镜与开放手术治疗腰椎间盘突出症的疗效与安全性.方法 对2004年1月至2014年1月中文科技期刊数据库（VIP）、万方数据库、中国知网、PubMed Central（PMC）数据库中相关文献进行电子检索以及手工检索,纳入椎间盘镜与开放手术治疗腰椎间盘突出症的随机对照试验,根据Jadad评分标准评价纳入研究项目的质量.采用RevMan 5.2统计软件进行Meta分析.结果 共纳入12个随机对照试验,合计1 338例患者,其中椎间盘镜组672例,开放手术组666例.Meta分析显示：椎间盘镜与开放手术比较,前者平均手术时间多于后者（P＜0.01）,术中出血量及平均住院天数少于后者（P＜0.01）,术后腰腿痛视觉模拟评分（VAS）明显优于后者（P＜0.01）,两组总有效率、术后肌酸磷酸激酶（CPK）水平、术后功能障碍指数（ODI）差异无统计学意义（P＞0.05）.结论 椎间盘镜与开放手术治疗腰椎间盘突出症都取得了良好疗效,在术中出血量、平均住院天数、术后腰腿痛改善方面椎间盘镜优于后者,但手术时间长于后者,总体疗效并无显著差异.
Objective To assess therapeutic effect of microendoscopic discectomy versus open discectomy for the treatment of lumbar disc herniation.Methods Literatures were searched from VIP,Wan Fang data,Chinese How Net and PubMed Central （PMC） data （2004.01-2014.01）.The quality of randomized controlled trials （RCT） was evaluated according to Jadad score standard,and Rev Man 5.2 was used for Meta-analysis.Results Tweleve studies involving 1 338 patients were included,of which 672 were subjected to microendoscopic discectomy and 666 to open discectomy.The results indicated that statistically significant difference was observed between two approaches with respect to the mean operation time （P＜0.01）,blood loss （P＜0.01）,hospital stay （P＜0.01） and postoperative visual analogue scale （VAS） score of back and leg pain （P ＜ 0.01）.No significant difference in the overall effectiveness,postoperative serum creatine phosphokinase （CPK） levels and postoperative oswestry disability index （ODI） were noted between two groups.Conclusion Both microendoscopic discectomy and open diseectomy are effective for lumbar disc herniation.Microendoscopic discectomy is superior to open discectomy in blood loss,hospital stay,and back and leg pain relief,but its operation time is longer than the latter.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2014年第8期1837-1839,共3页
Chinese Journal of Experimental Surgery
基金
湖北省教育厅资助项目（B20112115）
关键词
椎间盘镜
开放手术
腰椎间盘突出症
META分析
Microendoscopic discectomy
Open discectomy
Lumbar disc hemiation
Metaanalysis
