超早期血管内栓塞颅内破裂动脉瘤效果的Meta分析

发布时间：2018-09-09 12:25

【摘要】：目的系统评价比较超早期(24 h)与延期(≥24 h)血管内栓塞治疗颅内破裂动脉瘤的安全性和有效性。方法根据纳入、排除标准及检索策略,检索Pub Med、Embase、Cochrane图书馆、维普、万方数据和相关期刊论文等,获得超早期和延期应用血管内栓塞治疗颅内破裂动脉瘤的临床文献,采用Review Manager 5.3软件对治疗预后良好率、术后病死率、术后再出血率等进行Meta分析。结果共纳入10篇文献,其中9篇为回顾性对照研究,1篇为前瞻性对照研究。共纳入2 021例患者,其中采用超早期治疗的患者970例,采用延期治疗患者1 051例。超早期组患者的预后良好率(OR=2.67,95%CI:2.07~3.44)、术后再次出血率(OR=0.23,95%CI:0.11~0.47)与延期组差异均有统计学意义(均P0.01),而两组术后病死率差异无统计学意义(OR=0.76,95%CI:0.51~1.13,P=0.17)。亚组分析显示,超早期组的预后良好率与早期组(3 d,OR=1.98,95%CI:1.33~2.95)、中晚期组(≥3 d,OR=4.66,95%CI:2.21~9.81)比较,差异均有统计学意义(均P0.01)。结论超早期血管内栓塞治疗颅内破裂动脉瘤比延期治疗有可能提高预后良好率,减少再出血率,并未增加术后病死率。但尚需更多高质量、大样本的随机对照试验证实。
[Abstract]:Objective to evaluate the safety and efficacy of endovascular embolization in the treatment of intracranial ruptured aneurysms. Methods according to the inclusion, exclusion criteria and retrieval strategy, the Pub Med,Embase,Cochrane library, Weip, Wanfang data and the full text database of Chinese Journal were searched to obtain the clinical literature of endovascular embolization in the treatment of ruptured intracranial aneurysms. Review Manager 5.3 software was used to analyze the rate of good prognosis, postoperative mortality and postoperative rebleeding rate by Meta. Results A total of 10 articles were included, of which 9 were retrospective controlled studies and 1 prospective controlled study. A total of 2 021 patients were included, of whom 970 received super early treatment and 1 051 received delayed treatment. The rate of good prognosis (OR=2.67,95%CI:2.07~3.44), postoperative rebleeding rate (OR=0.23,95%CI:0.11~0.47) and delayed group were significantly different (P0.01), but there was no significant difference in mortality (OR=0.76,95%CI:0.51~1.13,P=0.17) between the two groups. The subgroup analysis showed that there were significant differences between the early group and the early group (1.98% CI: 1.33 2.95) and the middle and late stage group (鈮，

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