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[1]王一,李冷鋾,王瀾潔,等.中國人腰椎間盤突出后重吸收發(fā)生率的Meta分析[J].中醫(yī)正骨,2021,33(01):27-33.
　WANG Yi,LI Lengtao,WANG Lanjie,et al.Incidence of spontaneous resorption of lumbar disc herniation in Chinese:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(01):27-33.
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中國人腰椎間盤突出后重吸收發(fā)生率的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期數(shù):
2021年01期
頁碼:
27-33
欄目:
文獻研究
出版日期:
2021-01-20

文章信息/Info

Title:
Incidence of spontaneous resorption of lumbar disc herniation in Chinese:a meta analysis
作者:
王一1; 李冷鋾2; 王瀾潔1; 戴國鋼1
(1.四川省骨科醫(yī)院,四川 成都 610041; 2.成都體育學院運動醫(yī)學與健康學院,四川 成都 610041)
Author(s):
WANG Yi1; LI Lengtao2; WANG Lanjie1; DAI Guogang1
1.Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China2.School of Sports Medicine and Health of Chengdu Sport University,Chengdu 610041,Sichuan,China
關鍵詞:
腰椎;  椎間盤移位;  重吸收;  Meta分析;  系統(tǒng)評價
Keywords:
lumbar vertebrae;  intervertebral disc displacement;  spontaneous resorption;  meta-analysis;  systematic review
摘要:
目的:分析中國人腰椎間盤突出后重吸收的發(fā)生率。方法:計算機檢索中國知網(wǎng)、萬方數(shù)據(jù)庫、維普網(wǎng)2010年1月至2020年5月收錄的所有有關中國人腰椎間盤突出后突出的椎間盤組織體積變化的中文文獻,并手工檢索相關文獻。篩選文獻后提取隨訪患者總數(shù)、發(fā)生重吸收患者數(shù)量、研究類型、重吸收判斷方法(定性判斷或定量判斷)等重要數(shù)據(jù),使用隨機效應模型進行Meta分析,并進行亞組分析、敏感性分析、Meta回歸分析和發(fā)表偏倚分析。結果:共檢索到2301篇文獻,最終納入20篇文獻進行分析。20項研究共隨訪1214例患者,723例發(fā)生重吸收; 其中隨機對照試驗5項,前瞻性非隨機對照試驗11項,回顧性研究4項; 7項研究采用定量方法判斷重吸收情況,13項研究采用定性方法判斷重吸收情況。Meta分析結果顯示,腰椎間盤突出后重吸收的發(fā)生率為54%[I2= 98%,P=0.000; 95%CI(0.36,0.72)]。亞組分析顯示,隨機對照試驗、前瞻性非隨機對照試驗、回顧性研究的重吸收發(fā)生率比較,差異無統(tǒng)計學意義(Q=0.30,P=0.86); 采用定量和定性方法判斷重吸收情況的研究,重吸收發(fā)生率比較,差異無統(tǒng)計學意義(Q=0.14,P=0.70)。通過逐個剔除納入的研究進行敏感性分析,結果顯示腰椎間盤突出后重吸收發(fā)生率在50%[95%CI(0.33,0.67)]至58%[95%CI(0.41,0.75)]之間,提示Meta分析結果穩(wěn)定。Meta回歸分析顯示,研究類型(R2=0,P=0.820)和采用不同方法判斷重吸收(R2=15.34%,P=0.740)均不是異質性來源。Egger’s test未檢測到發(fā)表偏倚存在(P=0.130)。結論:中國人腰椎間盤突出后重吸收的發(fā)生率為54%,臨床上在選擇手術治療前應充分考慮腰椎間盤突出后重吸收的可能性。
Abstract:
To analyze the incidence of spontaneous resorption of lumbar disc herniation(LDH)in Chinese.Methods:All the Chinese articles about volume change of protrusion in Chinese LDH patients included from January 2010 to May 2020 were retrieved from China national knowledge internet,WanFang Database and VIP Database through computer.Meanwhile,all the relevant articles were manual retrieved.The information about total number of patients with follow-up,number of patients with spontaneous resorption of LDH,research type and qualitative and quantitative judgment method of spontaneous resorption were extracted from the articles,and Meta-analysis including subgroup analysis,sensitivity analysis,Meta regression analysis and publication bias analysis were conducted by using random effect model(REM).Results:Two thousand three hundred and one articles were searched out.After screening,20 articles(1214 patients with follow-up and 723 patients with spontaneous resorption of LDH)were included in the final analysis,including 5 randomized controlled trial(RCT)articles,11 prospective non-RCT articles and 4 retrospective trial articles.The spontaneous resorption was judged by quantitative method in 7 articles and qualitative method in 13 articles.The results of Meta-analysis demonstrated that the incidence rate of spontaneous resorption of LDH was 54%(I2=98%,P=0.000; 95%CI(0.36,0.72)).The results of subgroup analysis demonstrated that there was no statistical difference in the incidence rate of spontaneous resorption between RCT,prospective non-RCT and retrospective trial(Q=0.30,P=0.86)and between quantitative study and qualitative study(Q=0.14,P=0.70).The sensitivity analysis was performed through excluding the included articles in turn,and the results showed that the incidence rate of spontaneous resorption of LDH was between 50%(95%CI(0.33,0.67))and 58%(95%CI(0.41,0.75)),which suggested that the results of Meta analysis were stable.The results of Meta regression analysis demonstrated that both research type(R2=0,P=0.820)and judgment method(R2=15.34%,P=0.740)of spontaneous resorption were not the sources of heterogeneity.No publication bias was found by Egger’s test(P=0.130).Conclusion:The incidence rate of spontaneous resorption of LDH is 54% in Chinese.The possibility of spontaneous resorption of LDH should be fully considered before the surgical treatment in clinic.

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備注/Memo

備注/Memo:
基金項目:四川省衛(wèi)生和計劃生育委員會科研課題(16PJ389); 中國民族醫(yī)藥學會科研項目(2017KYXM-Z172-40); 四川省醫(yī)學會骨科(尚安通)專項科研課題(2019SAT06); 四川省骨科醫(yī)院院內課題(2017-4)
通訊作者:戴國鋼 E-mail:[email protected]
更新日期/Last Update: 2021-01-20