本文選題：腰椎間盤突出癥　切入點：后路顯微椎間盤鏡　出處：《石河子大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:利用Meta分析方法系統(tǒng)評價后路顯微椎間盤鏡腰椎間盤髓核摘除術(shù)(Microendoscopic Discectomy,MED)與傳統(tǒng)開窗腰椎間盤髓核摘除術(shù)(Open Lumbar Discectomy,OLD)治療腰椎間盤突出癥(Lumbar Disc Herniation,LDH)的臨床療效和安全性。方法:采用系統(tǒng)評價方法,計算機檢索Pub Med、Cochrane Library、EMBASE、MEDLINE、相關(guān)期刊論文、中國生物醫(yī)學文獻數(shù)據(jù)庫、萬方數(shù)據(jù)庫(1997年01月-2014年09月),手工檢索相關(guān)期刊。搜集應(yīng)用后路顯微椎間盤鏡腰椎間盤髓核摘除術(shù)和傳統(tǒng)開窗腰椎間盤髓核摘除術(shù)治療成人單節(jié)段腰椎間盤突出癥的隨機對照研究。2位作者獨立評估各研究的質(zhì)量,將各研究中的手術(shù)后療效、手術(shù)時間、術(shù)中失血量、住院時間等數(shù)據(jù)提取整理為電子基線表,并將這些研究的數(shù)據(jù)通過Rev Man 5.2軟件進行Meta分析與綜合。結(jié)果:共17篇研究符合納入標準,共計2551例樣本被納入分析研究。Meta分析結(jié)果顯示:與傳統(tǒng)開窗腰椎間盤髓核摘除術(shù)相比,后路顯微椎間盤鏡腰椎間盤髓核摘除術(shù)在術(shù)后療效(OR=1.22,95%CI:0.44~3.42,P=0.70)和手術(shù)時間(MD=2.22,95%CI:-2.37~6.80,P=0.34)方面差異無統(tǒng)計學意義;在術(shù)中出血量(MD=-81.24,95%CI:-111.00~-51.49,P0.01)、手術(shù)切口長度(MD=-2.88,95%CI:-4.09~-1.68,P0.01)、住院時間(MD=-3.67,95%CI:-5.44~-1.90,P0.01)、恢復日常生活時間(MD=-19.11,95%CI:-26.09~-12.13,P0.01)和術(shù)后臥床時間(MD=-9.09,95%CI:-13.28~-4.91,P0.01)方面差異有統(tǒng)計學意義。結(jié)論:后路顯微椎間盤鏡腰椎間盤髓核摘除術(shù)與傳統(tǒng)開窗腰椎間盤髓核摘除術(shù)治療單節(jié)段腰椎間盤突出癥,術(shù)后療效和手術(shù)操作時間相當;但后路顯微椎間盤鏡腰椎間盤髓核摘除術(shù)具有術(shù)中出血量少、手術(shù)切口小、住院時間、恢復日常生活時間及術(shù)后臥床時間短等優(yōu)點。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of microendoscopic discectomytomy (MED) and open Lumbar discectomy (OLDH) in the treatment of Lumbar Disc herniation of lumbar intervertebral disc herniation by Meta analysis. Methods: a systematic evaluation method was adopted, Computer search for Pub Medsite Cochrane Library EMBASE MEDLINE, full text Database of Chinese Journals, Chinese Biomedical Literature Database, Wanfang database (January 1997-September 2014), manual retrieval of relevant journals. Collection and application of posterior microdiscectomy and traditional fenestration for the treatment of single segment lumbar intervertebral disc process in adults. A randomized controlled study of 2. 2 authors independently assessed the quality of each study. The data of post-operative effect, operation time, blood loss during operation and hospital stay were extracted and sorted into an electronic baseline table. The data of these studies were analyzed and synthesized by Meta through Rev Man 5.2 software. Results: a total of 17 studies met the inclusion criteria. A total of 2551 samples were included in the study. Meta-analysis showed that compared with traditional fenestration of lumbar disc nucleus pulposus, There was no significant difference in the curative effect of posterior microdiscectomy for lumbar disc nucleus pulposus (1.2295% CI: 0.443.42% P0.70) and the time of operation (MD2.2295% CI-2.376.80% P0.34). The volume of intraoperative bleeding was MD-81.2495 CI-111.00 ~ -51.49% P0.01, the length of incision MD-2.895% CI-4.09 -1.68% P0.01, the length of hospitalization MD-3.695% CI-5.44-1.90 P0.01, the time of daily life recovery MD-19.1195CI-26.099-12.13P0.01) and the postoperative bed time MD-9.095 CI-13.28 ~ -4.91% P0.01.Conclusion: posterior discectomy has statistical significance compared with traditional discectomy. Fenestration of nucleus pulposus in the treatment of single segment protrusion of lumbar intervertebral disc, The curative effect was the same as the operative time, but the posterior microdiscectomy had the advantages of less blood loss, small incision, hospital stay, recovery time of daily life and short time of bed rest after operation.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

【參考文獻】

相關(guān)期刊論文 前10條

1 戴守達;董小雄;張耘;王永宏;張洪思;周正順;陳剛;呂峰;劉洪業(yè);韓順;;腰椎間盤突出癥傳統(tǒng)手術(shù)方式與內(nèi)窺鏡(MED)療效的回顧性分析[J];頸腰痛雜志;2010年05期

2 許斌;劉剛;趙建寧;王與榮;;椎間盤鏡下髓核摘除術(shù)學習曲線的探討[J];醫(yī)學研究生學報;2013年08期

3 曾憲濤;孫竹;湯紅明;;Meta分析系列之十:合格標準的制定[J];中國循證心血管醫(yī)學雜志;2013年01期

4 韋建勛;李榮祝;尹東;梁斌;孫可;莫冰峰;;顯微內(nèi)鏡椎間盤切除術(shù)與椎板間隙開窗術(shù)治療腰椎間盤突出癥的比較研究[J];微創(chuàng)醫(yī)學;2009年06期

5 華國軍;劉云鵬;駱宇春;朱建平;汪建良;蔡福金;;MED與傳統(tǒng)椎板開窗術(shù)治療腰椎間盤突出癥中期隨訪比較[J];江蘇醫(yī)藥;2009年01期

6 崔新廣;常增林;莊正陵;段俊虎;劉濤;;顯微內(nèi)鏡腰椎間盤切除術(shù)的常見問題及其處理[J];中國內(nèi)鏡雜志;2006年10期

7 楊維權(quán),劉大雄,孫榮華,王魁,吳曉峰,張連生;后中路椎間盤鏡手術(shù)的適應(yīng)證[J];中國矯形外科雜志;2002年09期

8 熊英輝;貝抗勝;劉建平;謝俊玲;唐華軍;張?zhí)?;顯微內(nèi)窺鏡下腰椎間盤髓核摘除術(shù)后中遠期療效分析[J];中國矯形外科雜志;2010年11期

9 尹俊;楊雙石;;顯微內(nèi)窺鏡椎間盤切除術(shù)治療腰椎間盤突出癥360例并發(fā)癥分析[J];中華臨床醫(yī)師雜志(電子版);2011年16期

10 沈合群,張葉松,蔣清;MED與開放手術(shù)治療腰椎間盤突出癥的療效比較[J];中國現(xiàn)代醫(yī)學雜志;2004年12期

，

本文編號：1613994