CAJ | 학술논문

背景：经皮椎体后凸成形治疗作为一种微创手术治疗骨质疏松椎体压缩性骨折证明是有效的，其具有简便的手术操作，安全的模式，能迅速缓解疼痛，明显恢复椎体高度。但目前对于单侧与双侧经皮椎体后凸成形治疗骨质疏松椎体压缩性骨折的效果还存在争议。 　　目的：利用Meta分析对于国内外应用单侧与双侧经皮椎体后凸成形治疗的对照试验进行荟萃分析，在样本量较大的前提下比较和评价两种治疗方案的有效性与优越性。 　　方法：收集PubMed、Web of Knowledge、中国期刊全文数据库、万方医学数据库、超星数据库关于单侧经皮椎体后凸成形与双侧经皮椎体后凸成形治疗的对照文献进行Meta分析，纳入语种包括中文、英文，时限设定在2000至2014年，其中单侧经皮椎体后凸成形治疗为试验组，双侧经皮椎体后凸成形治疗为对照组；疗效及差异评价指标以加权均数差和95%可信区间(CI)、RR值表示，运用Review Manager5.2软件进行统计分析。 　　结果与结论：共收集到国内外7篇随机对照试验，统计分析结果显示，2组病例目测类比评分均降低，但差异无显著性意义[RR=-0.08，95%CI(-0.05，-0.21)，P=0.21]；Cobb角变化差异无显著性意义[RR=-0.07，95%CI(-0.16，-1.47)，P=0.93]；椎体平均高度恢复比较差异无显著性意义[RR=-1.76，95%CI(-4.21，-0.69)，P=0.16]；单侧经皮椎体后凸成形治疗的手术时间较双侧经皮椎体后凸成形短[RR=-23.99，95%CI(-26.01，-21.97)，P<0.00001]。提示与双侧经皮椎体后凸成形治疗相比，单侧经皮椎体后凸成形治疗能有效减少手术操作时间；但在目测类比评分、Cobb角变化、椎体平均高度恢复方面两者在统计学范畴无明显差异。
배경：경피추체후철성형치료작위일충미창수술치료골질소송추체압축성골절증명시유효적，기구유간편적수술조작，안전적모식，능신속완해동통，명현회복추체고도。단목전대우단측여쌍측경피추체후철성형치료골질소송추체압축성골절적효과환존재쟁의。 　　목적：이용Meta분석대우국내외응용단측여쌍측경피추체후철성형치료적대조시험진행회췌분석，재양본량교대적전제하비교화평개량충치료방안적유효성여우월성。 　　방법：수집PubMed、Web of Knowledge、중국기간전문수거고、만방의학수거고、초성수거고관우단측경피추체후철성형여쌍측경피추체후철성형치료적대조문헌진행Meta분석，납입어충포괄중문、영문，시한설정재2000지2014년，기중단측경피추체후철성형치료위시험조，쌍측경피추체후철성형치료위대조조；료효급차이평개지표이가권균수차화95%가신구간(CI)、RR치표시，운용Review Manager5.2연건진행통계분석。 　　결과여결론：공수집도국내외7편수궤대조시험，통계분석결과현시，2조병례목측류비평분균강저，단차이무현저성의의[RR=-0.08，95%CI(-0.05，-0.21)，P=0.21]；Cobb각변화차이무현저성의의[RR=-0.07，95%CI(-0.16，-1.47)，P=0.93]；추체평균고도회복비교차이무현저성의의[RR=-1.76，95%CI(-4.21，-0.69)，P=0.16]；단측경피추체후철성형치료적수술시간교쌍측경피추체후철성형단[RR=-23.99，95%CI(-26.01，-21.97)，P<0.00001]。제시여쌍측경피추체후철성형치료상비，단측경피추체후철성형치료능유효감소수술조작시간；단재목측류비평분、Cobb각변화、추체평균고도회복방면량자재통계학범주무명현차이。
BACKGROUND:Percutaneous kyphoplasty, as a kind of minimal y invasive surgery, has been proved to be effective in the treatment of osteoporotic vertebral compression fractures. Percutaneous kyphoplasty has simple operation and safe mode, can relieve pain quickly, and obviously restore vertebral body height. However, the therapeutic effects of unipedicular and bipedicular percutaneous kyphoplasty for osteoporotic vertebral compression fractures are controversial. OBJECTIVE:To analyze control ed trials on the therapy with unipedicular and bipedicular percutaneous kyphoplasty using meta-analysis, and to compare the effectiveness and superiority of the two methods with a large sample size. METHODS:We retrieved PubMed, Web of Knowledge, China Journal Ful-text database, Wanfang database, and Super Star database for articles on meta-analysis of unipedicular versus bipedicular percutaneous kyphoplasty published from 2000 to 2014 in Chinese and English. Unipedicular percutaneous kyphoplasty served as experimental group and bipedicular percutaneous kyphoplasty as control group. Curative effect and the difference between evaluation indexes were expressed as the weighted mean difference and 95%confidence interval and the RR value. Statistical analysis was carried out using Review Manager 5.2 software. RESULTS AND CONCLUSION:A total of seven randomized control ed trials were col ected. Results of statistical analysis showed that visual analogus scale scores were decreased in both groups, but no significant difference was detected [RR=-0.08, 95%CI(-0.05,-0.21), P=0.21]. There was no significant difference in Cobb angle change [RR=-0.07, 95%CI(-0.16,-1.47), P=0.93]. No significant difference in the average recovered height of vertebral bodies was detected [RR=-1.76, 95%CI(-4.21, -0.69), P=0.16]. Operation time was shorter in unipedicular percutaneous kyphoplasty than in bipedicular percutaneous kyphoplasty [RR=-23.99, 95%CI(-26.01, -21.97), P<0.000 01]. These data indicated that compared with bipedicular percutaneous kyphoplasty, unipedicular percutaneous kyphoplasty could effectively reduce the operation time. However, no significant difference in visual analogus scale scores, Cobb angle change and the average recovered height of vertebral bodies was visible in statistical analysis in both groups.