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一例成人Ⅱ度峡部裂型腰椎滑脱的循证健康咨询 被引量：3

Evidence-Based Health Consult for Lumber Isthmic Spondylolisthesis Grading Ⅱ in Adult: A Case Report
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摘要 目的运用循证医学方法,为1例成人Ⅱ度峡部裂型腰椎滑脱的患者提供选择治疗方案的依据。方法在充分评估患者病情的基础上,根据PICO原则,提出临床问题,检索Cochrane图书馆、DARE、CENTRAL、MEDLINE、EMbase以及CBM,检索时限截至2011年4月,查找高质量临床证据,并告知患者相关治疗方案的临床疗效及并发症等情况。患者在充分知晓自身病情及治疗方法的情况下,选择合适的治疗方案。结果共纳入5篇系统评价、1篇Meta分析、3篇RCT及1篇关于本病自然病程的前瞻性研究。证据表明:峡部裂型腰椎滑脱的自然病程预后较好;若保守治疗效果不佳、疼痛不缓解、滑脱进展、严重影响生活质量时,可实施手术治疗;手术治疗后症状缓解的远期效果可能较好,但也不能改变本病的自然病程。综合文献信息并分析利弊后,患者选择了保守治疗的方法。经过约1年的保守治疗,该患者目前情况良好,腿部放射性疼痛有所缓解,CT检查结果显示腰椎滑脱无进展。结论轻度峡部裂型腰椎滑脱的患者采用保守治疗可取得较好疗效,但在保守治疗的过程中应定期随访,监测腰椎滑脱进展情况。 Objective To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading Ⅱ Methods Based on fully assessing the patient＇s conditions, the clinical problems were put for ward according to PICO principles. Such database as The Cochrane Library （2005 to April 2011）, DARE （April 2011）, CENTRAL （April 2011）, MEDLINE （April 2011）, EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans. Results We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment, After one year＇s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy. Conclusion Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.
作者 罗稀 李小麟
机构地区 四川大学华西护理学院
出处 《中国循证医学杂志》 CSCD 2013年第1期121-124,共4页 Chinese Journal of Evidence-based Medicine
关键词 腰椎滑脱 成人峡部裂型 手术治疗 保守治疗 循证护理 Spondylolisthesis Adult isthmic Surgery Conservative treatment Evidence-based nursing
分类号 R687.3 [医药卫生—骨科学]
  • 相关文献

参考文献13

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二级参考文献35

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中国循证医学杂志
2013年 第1期

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