侧脑室外引流联合腰大池引流治疗脑室出血的Meta分析

发布时间：2018-11-04 20:59

【摘要】：目的:对腰大池持续引流同时联合侧脑室外引流治疗脑室出血患者的治疗有效性进行合并研究,为以后脑室出血的患者提供更方便、更迅速、更具有针对性的治疗方法。方法:利用电子计算机,以脑室出血“Ventricular hemorrhage”;侧脑室外引流“Latreral ventriecle drainage”;腰大池持续引流“In a large waist pool drainage”为检索词。检索OVID、Pub Med、VIP、CBM、万方数据库、CNKI等中英文医学文献数据库,纳入关于治疗脑室出血的研究中使用腰大池持续引流同时联合脑室外引流的全部随机对照试验。结果:最终纳入409例脑室出血患者,共涉及7个研究。Meta分析结果显示:在治疗有效率方面,常规组明显低于联合组,其差异有明显的统计学意义[RR=1.86,95%CI(1.45,2.15),P0.00001];在结局指标病死率方面,常规组明显高于联合组,两组差异有统计学意义[RR=0.34,95%CI(0.20,0.58),P0.001];常规组的的血肿清除率明显较联合组的血肿清除率低,两组差异有统计学意义[RR=1.56,95%CI(1.28,1.90),P0.001];常规组患者脑积水在随访结束时的发生情况明显低于联合组,两组差异有统计学意义[RR=0.13,95%CI(0.04,0.70),P0.007]。由于对少部分患者的预后情况缺乏相关研究素材,暂时不能更加准确的分析腰大池持续引流联合侧脑室外引流对治疗脑室出血的影响。结论:腰大池持续引流同时结合侧脑室外引流的外科治疗方法,对于治疗脑室出血易于操作,对患者损伤较小。虽从本文能看出使用侧脑室外引流联合能有效降低患者的病死率和脑积水的发生率,对提高患者的生存率及愈后的生活质量有明显作用,但更期待更加高质量的临床研究。
[Abstract]:Objective: to study the efficacy of continuous lumbar cistern drainage combined with lateral ventricular external drainage in the treatment of ventricular hemorrhage in order to provide a more convenient, rapid and targeted treatment for the patients with ventricular hemorrhage. Methods: the key words were "Ventricular hemorrhage" (ventricular hemorrhage), "Latreral ventriecle drainage" (lateral ventricular drainage) and "In a large waist pool drainage" (continuous drainage of lumbar cistern) by computer. To search the OVID,Pub Med,VIP,CBM, Wanfang database, CNKI and other Chinese and English medical literature databases, all the randomized controlled trials in which the lumbar cistern continuous drainage combined with ventricular drainage were used in the study on the treatment of ventricular hemorrhage were carried out. Results: a total of 7 studies were involved in the patients with ventricular hemorrhage. The results of Meta analysis showed that the effective rate of treatment in routine group was significantly lower than that in combined group. The difference was statistically significant [RR=1.86,95%CI (1.45m2.15), P0.00001]; The mortality of the outcome index in the routine group was significantly higher than that in the combined group, and the difference between the two groups was statistically significant [RR=0.34,95%CI (0.20 卤0.58), P0.001]; The hematoma clearance rate of the routine group was significantly lower than that of the combined group, and the difference between the two groups was statistically significant [RR=1.56,95%CI (1.28 卤1.90), P0.001]; The incidence of hydrocephalus in the routine group was significantly lower than that in the combined group at the end of follow-up. The difference between the two groups was statistically significant [RR=0.13,95%CI (0.04 卤0.70), P 0.007]. Due to the lack of relevant research materials for the prognosis of a few patients, it is not possible to analyze more accurately the effect of continuous lumbar cistern drainage combined with lateral ventricular external drainage on the treatment of ventricular hemorrhage. Conclusion: the surgical treatment of continuous lumbar cistern drainage combined with lateral ventricular external drainage is easy to operate and less injuried to patients with ventricular hemorrhage. Although it can be seen from this paper that the use of lateral ventricular external drainage can effectively reduce the mortality and the incidence of hydrocephalus, and improve the survival rate and the quality of life of the patients, it is expected to have a higher quality of clinical research.
【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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