动脉瘤性SAH手术夹闭与介入栓塞疗效及并发症的Meta分析

发布时间：2018-03-24 14:42

本文选题：动脉瘤　切入点：蛛网膜下腔出血　出处：《医学研究杂志》2016年11期

【摘要】：目的评价动脉瘤性蛛网膜下腔出血后经不同术式治疗的患者其预后及术后并发症发生率有无统计学差异。方法在Medline、Embase、Cochrane等文献数据库中对近20年内发表的关于手术夹闭及介入栓塞治疗颅内破裂动脉瘤的对比研究进行检索。由2名评价者独立的筛选出符合纳入标准的文献,并用Review Manager 5.3软件进行Meta分析。结果共纳入11篇文献,合计4970例患者。比较两种术式术后脑血管痉挛、脑积液的发生率,经Meta分析,其OR值(95%CI)分别为1.23(0.77~1.95)、0.90(0.70~1.15),差异均无统计学意义(P0.05)。固定效应模型分析术后不良预后的发生率OR值(95%CI)为1.38(1.15~1.66),差异有统计学意义(P0.05);随机效应模型分析术后不良预后的发生率OR值(95%CI)为1.33(0.91~1.96),差异无统计学意义(P0.05)。结论接受不同术式治疗的动脉瘤破裂患者,其术后脑血管痉挛、脑积液的发生率没统计学差异;不能说明开颅夹闭术后患者不良预后的发生率高于接受介入栓塞治疗的患者。
[Abstract]:Objective to evaluate the prognostic and postoperative complications of patients with aneurysm subarachnoid hemorrhage (SAH) treated with different surgical methods. Methods the surgical clips published in Medlinea Embase Cochrane and other literature databases in recent 20 years were reviewed. A comparative study of closed and interventional embolization in the treatment of ruptured intracranial aneurysms was carried out. Documents that met the inclusion criteria were independently screened by two evaluators. Meta analysis was carried out with Review Manager 5.3 software. Results 4970 patients were included in 11 literatures. The incidence of cerebral vasospasm and cerebral effusion were analyzed by Meta. The odds ratio (OR) was 1.23 / 0.77 / 1.95 / 0.90 / 0.701.15, respectively, with no significant difference (P 0.05). The OR value of fixed effect model (95 CI) was 1.381.151.66 (P 0.05), and the OR value of random effect model was 0.701.15 (P < 0.05), and the OR value of random effect model was significant (P < 0.05) in the analysis of adverse prognosis after operation (P < 0.05). The odds ratio (OR) of fixed effect model in the analysis of postoperative adverse prognosis was 1.38 卤1.151.66 (P < 0.05). The CII was 1.33 / 0.91 / 1.96, with no significant difference (P 0.05). Conclusion the patients with ruptured aneurysms received different surgical procedures, The incidence of cerebral vasospasm and cerebral effusion was not significantly different after operation, which could not indicate that the incidence of poor prognosis after craniotomy was higher than that of patients receiving interventional embolization.
【作者单位】：石河子大学医学院;中国人民解放军兰州军区乌鲁木齐总医院神经外科;
【分类号】：R651.1

【参考文献】