后路腰椎间盘镜与传统开放椎间盘切除术治疗腰椎间盘突出症疗效的Meta分析

To evaluate the clinical effects of micro endoscopic discectomy operation and traditional open discectomy for the treatment of lumbar disc herniation: a meta analysis

目的:对腰椎间盘镜手术(micro endoscopic discectomy,MED)与传统开放椎间盘切除术(opening discectomy,OD)治疗腰椎间盘突出症的疗效及安全性进行Meta分析。方法:计算机检索2006年1月至2015年1月Pub Med、Embase、Cochrane library、万方数据库、中国知网、维普数据库、中文科技期刊数据库,全面收集有关腰椎间盘镜与传统开放腰椎间盘切除术治疗腰椎间盘突出症疗效与安全性研究的随机对照试验,用改良Jadad量表评分,纳入符合研究质量的文章。采用RevMan5.3软件进行Meta分析。结果:共纳入10个随机对照试验,1 198例患者,其中椎间盘镜组599例,传统开放手术组599例。Meta分析结果显示:手术时间MED短于OD(P<0.05)、术中出血量MED少于OD(P<0.05)、切口长度MED小于OD(P<0.05)、术后住院时间MED短于OD(P<0.05)、术后腰腿痛视觉模拟评分两者无差别(P>0.05)。结论:腰椎间盘镜下椎间盘切除术治疗腰椎间盘突出症,具有创伤小、出血少、手术时间短、术后住院时间短等优势,但术后腰腿痛视觉模拟评分两者无明显差别。

Objective： To explore the efficacy and safety of micro endoscopic discectomy operation and traditional open discectomy in the treatment of lumbar disc herniation with the methods of Meta analysis. Methods： Search Pub Med,Embase,Cochrane Library,Wanfang database,CNKI,CQVIP,Chinese science and technology periodical database（ from January 2006 to January 2015）,and collect the controlled trial for treatment of lumbar disc herniation with microendoscope and traditional open disc operation using the modified Jadad scale score,included in the study of the quality of the article. This meta analysis was carried out using Rev Man 5. 3 statistical software. Results： There are 10 randomized controlled trials,1198 patients（ MED group 599,OD group 599）. Meta analysis results showed： Operation time of MED is shorter than OD（ P 〈 0. 05）,amount of bleeding during operation of MED is less than OD（ P 〈0. 05）,incision length of Med is less than OD（ P 〈 0. 05）,hospitalization time of Med is shorter than OD（ P 〈 0. 05）,post operative pain visual analogue scale is no difference in MED and OD（ P 〉 0. 05）. Conclusion： MED technique leads to less surgical during,blood loss,small incision and Hospitalization time. But there is no significant difference in postoperative pain visual analogue scale between the 2 groups.