【摘要】：目的:用Meta分析的方法對(duì)單雙側(cè)經(jīng)皮椎體成形術(shù)(Percutaneous Vertebroplasty,PVP)治療骨質(zhì)疏松性椎體壓縮骨折(Osteoporotic vertebral compression fractures,OVCF)的臨床療效進(jìn)行對(duì)比分析。方法:數(shù)據(jù)庫(kù)檢索1987年1月至2016年12月,包括PubMed,Springer,EMBASE,OVID,Web of science,Cochrane central register of controlled trial,CNKI,萬(wàn)方數(shù)據(jù)庫(kù)。手工檢索《Spine》,《Euro Spine》,《中華骨科雜志》,《中國(guó)脊柱脊髓》等雜志。按納入和排除標(biāo)準(zhǔn)收集文獻(xiàn),進(jìn)行異質(zhì)性評(píng)價(jià)和偏倚評(píng)價(jià),用Review Manager 5.3進(jìn)行數(shù)據(jù)分析。結(jié)果:亞組分析和匯總顯示VAS評(píng)分在術(shù)后3月時(shí),雙側(cè)椎弓根組評(píng)分低于單側(cè)組(Z=2.47,P=0.01)。在其他亞組沒(méi)有明顯統(tǒng)計(jì)學(xué)差異。匯總后分析顯示雙側(cè)組評(píng)分低于單側(cè)組(Z=2.93,P=0.003)。骨質(zhì)疏松癥患者生活評(píng)分(QUALEFFO)在術(shù)后3月,6月,12月均有顯著差異,雙側(cè)椎弓根組評(píng)分低于單側(cè)組(Z=5.81,P0.00001)。單雙側(cè)組術(shù)后Oswestry功能障礙指數(shù)評(píng)分沒(méi)有明顯統(tǒng)計(jì)學(xué)差異(Z=0.45,P=0.65)。雙側(cè)組在手術(shù)時(shí)間及骨水泥注入量上明顯超過(guò)單側(cè)組(P0.00001),兩組間的骨水泥滲漏率間的比較卻沒(méi)有統(tǒng)計(jì)學(xué)的差異(P=0.65)。結(jié)論:單側(cè)組能縮短手術(shù)時(shí)間,減少骨水泥注入量,在術(shù)后即刻疼痛緩解上和功能活動(dòng)上能獲得滿意效果,但隨著隨訪時(shí)間的延長(zhǎng),雙側(cè)椎弓根組在疼痛緩解和生活質(zhì)量上優(yōu)于單側(cè)組。
[Abstract]:Objective: to compare the clinical efficacy of Percutaneous Vertebroplasty (Percutaneous Vertebroplasty) in the treatment of osteoporotic vertebral compression fracture (Osteoporotic vertebral compression fracture) by Meta. Methods: the database was searched from January 1987 to December 2016. Manual search < Spine >, < Euro Spine >, Chinese Journal of Orthopaedics, Chinese Spine and Spinal Cord, et al. Literature was collected according to inclusion and exclusion criteria, heterogeneity and bias were evaluated, and data were analyzed with Review Manager 5.3. Results: the subgroup analysis and summary showed that the score of VAS in bilateral pedicle group was lower than that in unilateral group at 3 months after operation. There was no significant difference in other subgroups. The score of bilateral group was lower than that of unilateral group (ZT2.93 P0. 003). The (QUALEFFO) scores of osteoporosis patients were significantly different in 3 months, 6 months and 12 months after operation, and the scores in bilateral pedicle group were lower than those in unilateral group (P 0.00001). There was no significant difference in the score of Oswestry dysfunction index between the unilateral and bilateral groups (P < 0. 65). The time of operation and the amount of bone cement injection in bilateral group were significantly higher than that in unilateral group (P0.00001), but there was no statistical difference between the two groups in the rate of bone cement leakage (P0. 65). Conclusion: unilateral group can shorten the operation time, reduce the amount of bone cement injection, and obtain satisfactory results in immediate pain relief and functional activity after operation, but with the extension of follow-up time. Bilateral pedicle group was superior to unilateral group in pain relief and quality of life.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R687.3

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