经侧裂—岛叶入路与颞叶皮层入路手术治疗高血压基底节区脑出血疗效对比的系统评价

发布时间：2018-05-11 13:20

本文选题：高血压基底节区脑出血 + 经侧裂-岛叶入路　；参考：《山西医科大学》2015年硕士论文

【摘要】：目的:对比研究经侧裂-岛叶入路与经颞叶皮层入路手术治疗高血压基底节区脑出血的疗效为临床上外科治疗术式选择上提供循证医学依据。方法:通过计算机检索中国知网、万方医学、中国文献数据库(CBM和中文科技期刊数据库(维普网),收集国内公开发表的比较经侧裂-岛叶和颞叶皮层入路的随机对照试验(RCT)检索时限为建库至2014.12。并逐一进行文献质量评价和资料提取。文献的质量评价参考Coachrane协作网提供Rev Man5.1软件进行Meta分析。结果:最终共纳入19个病例-对照研究,共计1609例受试者,其中包括806例经侧裂-岛叶入路行手术治疗的患者和803例经颞叶皮层入路治疗的患者,Meta分析的结果显示:①GOS:TR组的近期预后高于TE组,其差异有统计学意义[0R=2.15,95%CI(1.37,3.37),P=0.0009];②ADL:TR组的远期预后高于TE组,其差异有统计学意义[0R=2.81,95%CI(2.05,3.86),P0.0001];③术后并发症:TR组的远期预后高于TE组,其差异有统计学意义[0R=0.34,95%CI(0.24,0.49),P0.00001]④再出血:TR组的术后再出血低于TE组,其差异有统计学意义[0R=0.35,95%CI(0.19,0.66),P=0.001];⑤死亡率:TR组的死亡率低于TE组,其差异有统计学意义[0R=0.35,95%CI(0.20,0.62),P=0.0003]。结论:现有临床研究资料显示:(1)经侧裂-岛叶入路与经颞叶皮层入路对患者在术后6个月以内、12个月以后预后的影响,经侧裂-岛叶入路手术治疗的病人不良预后发生率要低于经颞叶皮层入路术后的病人。(2)经侧裂-岛叶入路较经颞叶皮层入路手术治疗高血压基底节区脑出血术后并发症的发生率、再出血发生率、术后死亡率有所下降。
[Abstract]:Objective: to compare the therapeutic effects of lateral fissure-insular approach and temporal cortex approach in the treatment of hypertensive basal ganglia intracerebral hemorrhage. Methods: a computer search was carried out on the Chinese Medicine of Zhiwang, Wanfang Medicine, The search time of CBM and Chinese Journal of Science and Technology (CBM) and Chinese Journal of Science and Technology (WIP), which were collected and published in China, were compared with the RCTs of lateral fissure and temporal lobe cortex pathway. The retrieval time of RCTs was built up to December 12, 2014. And one by one literature quality evaluation and data extraction. The quality evaluation of the literature refers to the Coachrane cooperation network to provide Rev Man5.1 software for Meta analysis. Results: a total of 19 case-control studies were conducted, with a total of 1609 subjects. A meta-analysis of 806 patients with lateral fissure / insular approach and 803 patients with transtemporal cortex approach showed that the short-term prognosis of the 1 GOS: tr group was higher than that of the te group. There was significant difference in the long-term prognosis between the two groups [0.37 ~ 3.37 ~ 0.0009] the long term prognosis of ADL: tr group was higher than that of te group, and the difference was statistically significant [0R 2.81 ~ 95CII 2.05V 3.86P0.0001] 3. The long term prognosis in the + tr group was higher than that in the te group, and the long-term prognosis was higher in the + tr group than in the te group, and there was a significant difference in the long-term prognosis between the two groups (P 0.0001), and the long-term prognosis was higher in the + tr group than in the te group. The difference was statistically significant [0RU 0.3495 CIQ 0.240.49 / P 0.00001] 4 the postoperative rebleeding in the rebleeding TR group was lower than that in the te group, and the difference was statistically significant [0RRU 0.35,95CI0.190.66 P0. 001] 5 the mortality rate in the% tr group was lower than that in the te group, and the difference was statistically significant [0RU 0.35% 95CI 0.20 0. 62P0.0003]. Conclusion: the available clinical data show that the effect of translateral fissure / insular approach and transtemporal cortex approach on the prognosis of patients within 6 months and 12 months after operation. The incidence of adverse prognosis was lower in patients treated with lateral fissure and insular approach than that in patients undergoing transtemporal cortex approach (P < 0.05). The incidence of adverse prognosis was lower than that in patients with hypertensive basal ganglia hemorrhage via transtemporal cortex approach than that in patients with hypertensive basal ganglion intracerebral hemorrhage treated by transtemporal cortex approach. Incidence of complications, The incidence of rebleeding and postoperative mortality decreased.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

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