我国微创手术治疗腰椎间盘突出症疗效系统性评价

A Systemic Evaluation on the Efficacy of Minimally Invasive Surgery in treating Lumbar Disc Herniation

目的:运用循证医学meta分析方法评价微创手术治疗腰椎间盘突出症的价值。方法:从电子数据库检索来源于CBM、CNKI、VIP和WANFANG DATA,收集2000年1月-2016年12月发表的有关微创手术治疗腰椎间盘突出症的随机对照试验研究。用meta分析对两组的恢复率、手术出血量、住院天数、手术切口长度、手术时间进行评价。结果:共纳入30篇文献,包括4 654例患者。结果显示,微创手术组术后恢复优良率(91.8%)高于对照组(88.8%),OR值及95%CI为1.58(1.27,1.97),差异有统计学意义(Z=4.14,P=0.000);微创组手术出血量、住院天数、手术切口长度、手术时间均低于对照组。结论:微创手术治疗腰椎间盘突出症疗效优于传统手术。

Objective To evaluate the efficacy of minimally invasive surgery in treating lumbar disc herniation. Methods Meta analysis was applied in the study. All papers reporting randomized controlled trial study for lumbar disc herniation treatment with minimally invasive surgery in the electronic databases CBM, CNKI, VIP, and Wanfang from January 2000 to December 2016 were collected. The postoperative excellent rate, the amount of hemorrhage, hospitalization time, incision length, and operation time were compared between the minimally invasive and conventional surgery groups. Results A total of 30 papers with 4654 patients were included in this study. The postoperative excellent rate of the minimally invasive surgery group （ 91.8% ） was higher than that of control group （ 88.8% ）. The related OR （ 95% CI） was 1.58 （ 1.27,1.97）, and the difference was statistically significant （Z = 4.14, P= 0.000）. The amount of hemorrhage, hospitalization time, incision length, and operation time of the minimally invasive group were significantly lower than that of the control group. Conclusion The minimally invasive surgery was more effective than the traditional operation in treating lumbar disc herniation.