本文選題：meta分析 + 腰椎融合　； 參考：《山西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的:均有大量文獻(xiàn)報道PLIF和TLIF兩種方法治療成人腰椎滑脫癥獲得了滿意的療效,但哪種方法更具優(yōu)勢尚缺乏文獻(xiàn)報道。收集文獻(xiàn)資料,采用Meta分析的方法對比研究PLIF和TLIF兩種方法治療成人腰椎滑脫癥的療效,為臨床決策提供證據(jù)。方法:在PUBMED、MEDLINE、CNKI及Cochrane Collaboration Library數(shù)據(jù)庫中檢索自1950年至2015年2月的隨機(jī)對照試驗(RCTs,relevant randomized controlled trials)和觀察對照研究。按照納入排除標(biāo)準(zhǔn)對文獻(xiàn)進(jìn)行篩選,對研究涉及的主要結(jié)局指標(biāo)文獻(xiàn)中應(yīng)有詳細(xì)的數(shù)據(jù)結(jié)果。按照Grade指南對文獻(xiàn)中的證據(jù)進(jìn)行質(zhì)量評估。結(jié)果:經(jīng)檢索沒有符合標(biāo)準(zhǔn)的隨機(jī)對照試驗,最后共納入5篇對照研究文獻(xiàn)。PLIF組和TLIF組在臨床滿意度中無顯著性差異(OR=0.94;95%CI=0.54-1.61;P=0.81)。PLIF組和TILF組的滿意率分別為83.0%和83.9%。在PLIF組和TLIF組之間,手術(shù)并發(fā)癥發(fā)生率存無顯著性差異(OR=4.67;95%CI=0.46-47.63;P=0.10)。并發(fā)癥的發(fā)生率在兩組中分別為8.29%和2.73%。PLIF組和TLIF組的融合率分別為98.3%和98.4%。兩組間的融合率無統(tǒng)計學(xué)差異(OR=1.15;95%CI=0.21-6.20;P=0.87)。來自其中兩個研究的融合率兩組均為100%,另外兩個研究中PLIF組和TLIF組的融合率分別為91.7%和96.7%。結(jié)論:PLIF和TLIF在治療成人腰椎滑脫癥中的臨床滿意度、圍手術(shù)期并發(fā)癥發(fā)生率、融合率均無統(tǒng)計學(xué)差異,兩種方法均能較好地緩解患者腰痛、腿疼、間歇性跛行等癥狀,可以認(rèn)為PLIF和TLIF對于成人腰椎滑脫癥的治療具有相同的優(yōu)勢。但本次meta分析納入文獻(xiàn)較少、納入病例數(shù)較少,證據(jù)質(zhì)量等級較低,對這一結(jié)果應(yīng)謹(jǐn)慎解讀。
[Abstract]:Objective: both PLIF and TLIF have been reported to be effective in the treatment of adult lumbar spondylolisthesis. To compare the efficacy of PLIF and TLIF in the treatment of adult lumbar spondylolisthesis by Meta-analysis. Methods: random controlled trials (RCTs) and observational controlled trials (RCTs) were searched in PUBMED MEDLINEN CNKI and Cochrane collaboration Library database from 1950 to February 2015. According to the exclusion criteria, the literature should be screened, and detailed data should be obtained in the literature on the main outcome indicators involved in the study. Evaluate the quality of the evidence in the literature in accordance with Grade guidelines. Results: there was no significant difference in clinical satisfaction between PLIF group and TLIF group after searching for no randomized controlled trial according to the standard. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. The satisfaction rates of PLIF group and TLIF group were 83.0% and 83.9%, respectively. There was no significant difference in the incidence of surgical complications between PLIF group and TLIF group (OR4.6795 CI 0.46-47.63P0.10). The incidence of complications was 8.29% in both groups and 98.3% in PLIF group and 98.4% in TLIF group. There was no significant difference in the fusion rate between the two groups. The fusion rates were 91.7% in PLIF group and 96.7% in TLIF group, respectively. Conclusion there is no significant difference in clinical satisfaction, perioperative complications and fusion rate between the two groups in the treatment of adult lumbar spondylolisthesis. The two methods can relieve the symptoms of low back pain, leg pain and intermittent claudication. PLIF and TLIF have the same advantages in the treatment of adult lumbar spondylolisthesis. However, the meta analysis included less literature, fewer cases and lower quality of evidence, which should be interpreted carefully.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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相關(guān)期刊論文 前2條

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