【摘要】：目的:通過比較前路、后路手術(shù)治療胸腰椎爆裂性骨折的療效來確定適合的治療方式。方法:檢索MEDLINE(Pub Med)、Embase和Cochrane Central Registry of Controlled Trials中關(guān)于胸腰椎爆裂性骨折前后路手術(shù)選擇的相關(guān)文獻(xiàn),對2014年10月之前相關(guān)的隨機(jī)對照實驗和對比觀察實驗進(jìn)行歸納,對納入文獻(xiàn)的質(zhì)量進(jìn)行評價后,提取所有文獻(xiàn)中實驗設(shè)計、病例特征、干擾因素、隨訪率及時間、實驗結(jié)果并分析。結(jié)果:納入7項實驗,包括2項隨機(jī)對照實驗、5項對比觀察實驗,共382名患者。后路手術(shù)組在術(shù)后脊柱后凸畸形矯正(P0.00001)和隨訪末脊柱后凸畸形矯正(P0.00001)要優(yōu)于前路手術(shù)組,兩組在隨訪末神經(jīng)功能改善(P=0.14)、術(shù)后并發(fā)癥(P=0.38)、因器械引起的術(shù)后并發(fā)癥(P=0.41)方面無明顯差異;在手術(shù)時間(P=0.003)、手術(shù)平均失血量(P0.00001)、住院時間(P0.00001)上,前路手術(shù)組均顯著高于后路手術(shù)組;后路手術(shù)組的術(shù)后椎管內(nèi)侵占水平(P0.00001)較前路手術(shù)組高。結(jié)論:后路手術(shù)在糾正脊柱后突畸形方面有良好的效果,而且具有手術(shù)出血量更少、手術(shù)時間及住院時間更短等特點(diǎn),兩種術(shù)式在術(shù)后并發(fā)癥及患者健康狀況調(diào)查問卷(SF-36)中大部分指標(biāo)上無明顯差異,本研究納入樣本量較小可能導(dǎo)致結(jié)果的偏倚。
[Abstract]:Objective: to compare the curative effect of anterior and posterior surgery in the treatment of thoracolumbar burst fracture. Methods: the literature on the selection of anterior and posterior approach for thoracolumbar burst fracture in MEDLINE (Pub Med), Embase and Cochrane Central Registry of Controlled Trials was searched, and the related randomized controlled trials and comparative observation experiments before October 2014 were summarized. After evaluating the quality of the included literature, the experimental design, case characteristics, interference factors, follow-up rate and time, experimental results were extracted and analyzed. Results: a total of 382 patients were included in 7 trials, including 2 randomized controlled trials and 5 comparative observation experiments. The correction of kyphosis after operation (P0.00001) and the correction of kyphosis at the end of follow-up (P0.00001) in the posterior operation group were better than those in the anterior operation group. At the end of follow-up, the neurological function of the two groups was improved (P 鈮，

本文編號：2480543