本文選題：腰椎間盤(pán)突出癥　切入點(diǎn)：后路顯微椎間盤(pán)鏡　出處：《石河子大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:利用Meta分析方法系統(tǒng)評(píng)價(jià)后路顯微椎間盤(pán)鏡腰椎間盤(pán)髓核摘除術(shù)(Microendoscopic Discectomy,MED)與傳統(tǒng)開(kāi)窗腰椎間盤(pán)髓核摘除術(shù)(Open Lumbar Discectomy,OLD)治療腰椎間盤(pán)突出癥(Lumbar Disc Herniation,LDH)的臨床療效和安全性。方法:采用系統(tǒng)評(píng)價(jià)方法,計(jì)算機(jī)檢索Pub Med、Cochrane Library、EMBASE、MEDLINE、相關(guān)期刊論文、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)、萬(wàn)方數(shù)據(jù)庫(kù)(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(pán)鏡腰椎間盤(pán)髓核摘除術(shù)和傳統(tǒng)開(kāi)窗腰椎間盤(pán)髓核摘除術(shù)治療成人單節(jié)段腰椎間盤(pán)突出癥的隨機(jī)對(duì)照研究。2位作者獨(dú)立評(píng)估各研究的質(zhì)量,將各研究中的手術(shù)后療效、手術(shù)時(shí)間、術(shù)中失血量、住院時(shí)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(guò)Rev Man 5.2軟件進(jìn)行Meta分析與綜合。結(jié)果:共17篇研究符合納入標(biāo)準(zhǔn),共計(jì)2551例樣本被納入分析研究。Meta分析結(jié)果顯示:與傳統(tǒng)開(kāi)窗腰椎間盤(pán)髓核摘除術(shù)相比,后路顯微椎間盤(pán)鏡腰椎間盤(pán)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(shí)間(MD=2.22,95%CI:-2.37~6.80,P=0.34)方面差異無(wú)統(tǒng)計(jì)學(xué)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(zhǎng)度(MD=-2.88,95%CI:-4.09~-1.68,P0.01)、住院時(shí)間(MD=-3.67,95%CI:-5.44~-1.90,P0.01)、恢復(fù)日常生活時(shí)間(MD=-19.11,95%CI:-26.09~-12.13,P0.01)和術(shù)后臥床時(shí)間(MD=-9.09,95%CI:-13.28~-4.91,P0.01)方面差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:后路顯微椎間盤(pán)鏡腰椎間盤(pán)髓核摘除術(shù)與傳統(tǒng)開(kāi)窗腰椎間盤(pán)髓核摘除術(shù)治療單節(jié)段腰椎間盤(pán)突出癥,術(shù)后療效和手術(shù)操作時(shí)間相當(dāng);但后路顯微椎間盤(pán)鏡腰椎間盤(pán)髓核摘除術(shù)具有術(shù)中出血量少、手術(shù)切口小、住院時(shí)間、恢復(fù)日常生活時(shí)間及術(shù)后臥床時(shí)間短等優(yōu)點(diǎn)。
[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(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.3

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本文編號(hào)：1613994