经皮椎间孔镜与传统开放性手术治疗老年腰椎间盘突出的Meta分析

A Meta-Analysis of Percutaneous Transforaminal Endoscopic Discectomy versus Traditional Open Surgery for Lumbar Disc Herniation in the Elderly

摘要: 目的：为评价经皮椎间孔镜手术与传统开放性手术治疗老年腰椎间盘突出症的临床疗效进行Meta分析。方法：检索Pubmed、Cochrane Library、Web of Science、Embase、Clinicaltrials.gov、CBM、CNKI、VIP、万方医学数据库，截止时间2021年3月31日。本研究提取的评价指标包括：伤口大小、失血量及VAS评分等指标。数据分析使用Revman5.3软件。结果：共纳入文献14篇，随机对照6篇，病例对照研究8篇，647例行经皮椎间孔镜手术，648例行传统开放性手术。Meta分析结果显示：经皮椎间孔镜手术与传统开放性手术相比，二者在手术时间、伤口大小、失血量、住院时间、末次随访VAS评分、末次随访ODI评分、临床疗效优良比较及出现并发症的比例上，两组间比较有统计学差异(P < 0.05)。结论：经皮椎间孔镜手术与传统开放性手术治疗腰椎间盘突出症时，经皮椎间孔镜术式具有失血量少、伤口小、住院天数短、临床疗效好、并发症少的优势。

Abstract: Objective: Do a meta-analysis to evaluate the clinical outcomes of percutaneous transforaminal en-doscopic discectomy and traditional open surgery on elderly patients with lumbar disc herniation (LDH). Methods: Databases including Pubmed, Cochrane Library, Web of science, Embase, Clini-laltrails.gov, CBM, CNKI, VIP, Wanfang data from inception to March 31st, 2021 to collect the pub-lished articles and studies about PTED versus traditional open surgery for treatment of LDH. The data included incision size, operation time, blood loss, bed time, VAS and etc. Revman 5.3 was used for data analysis. Results: The study including six randomized controls studies and eight case-control studies. PTED is performed in 647 cases and traditional open surgery is performed in 648 cases. The results showed that there were significant difference in incision size, operation time, blood loss, bed time, last postoperative VAS score, last postoperative ODI score, last modified MACNAB scare and complications rate. The comparison of the two in the above aspects was statisti-cally significant (P < 0.05). Conclusion: PTED has the advantages of less blood loss, small wound, short hospital stay, good clinical efficacy and fewer complications.