文献简介

出版社:Int J Clin Exp Med

作  者:Xiaoping Mu, Jianxun Wei, Peifeng Li

编  号:

关键字:Lumbar disc herniation | micro-endoscopic discectomy | open discectomy | efficiency | meta-analysis

年  份:2015   点击量:641

文献摘要 全文翻译

        The purpose of this study was to compare the safety and efficacy of micro-endoscopic discectomy (MED) and open discectomy (OD) for lumbar disc herniation (LDH). Randomised controlled trials (RCTs) comparing MED with OD for LDH were searched comprehensively in PubMed, EMBASE, the Cochrane Library. Relevant studies retrieved, data extracted and the quality of included studies were independently performed by two authors. RevMan software (Version 5.2.0) was used toanalyse and synthesis relevant data of the included studies. Nine RCTs involving 774 patients were obtained and reported the relevant outcome measures. Compared with OD group, there were significant difference in the general operation indicators including operation time, blood loss, site of incision, hospital stay and time of return to work,biochemical indexes including C-reactive protein (CRP) and interleukin-6 (IL-6) in MED group. Meanwhile, there were no difference in effective rate, complication including total complications, dural leaks occurred and recurrence of the disc herniation, compared MED group with OD group. MED had slighter trauma, milder blood loss and shorter healing time than OD. The results demonstrated MED has great efficacy and safety comparable to OD. So we think that MED can be used routinely for LDH patients, especially the patients of old and intolerable major surgery. Meanwhile, it is necessary for surgeon to master indication and contraindication of MED and improve the operative technique.

        本研究旨在比较采用显微内窥镜下椎间盘摘除术(MED)与开放式椎间盘切除术(OD)治疗腰椎间盘突出症(LDH)的安全性和有效性。基于PubMed、EMBASE、Cochrane图书馆的全面检索,比较MED与OD治疗LDH的随机对照试验(RCT)。两位学者对相关研究的检索、数据提取,以及纳入的文献质量进行了独立研究。应用RevMan软件(版本5.2.0)来分析和综合纳入研究的相关数据。涉及774例患者的9项RCT得出结果并报道相关疗效的判定指标。与OD组相比,MED组的一般手术指标存在显著性差异,其中包括手术时间、出血量、切口部位、住院时间及重返工作岗位的时间,生化指标包括C反应蛋白(CRP)和白细胞介素-6(IL -6)。同时,比较MED组与OD组的有效治愈率,并发症包括一般并发症均无差异,均出现了硬膜渗漏以及椎间盘突出症的复发。与OD相比,MED创伤轻微,失血较少以及愈合时间更短。结果表明:MED比OD有更好的疗效和安全性。因此,我们认为MED可为常规LDH患者治疗采用,尤其是老年患者以及难耐大手术的患者。同时,外科医生有必要掌握MED的适应证与禁忌,并提高手术技术。