栓塞与夹闭治疗前交通动脉瘤有效性及安全性的meta分析

发布时间：2018-12-13 05:14

【摘要】：目的:探讨前交通动脉瘤最佳的手术方式，为以后的治疗提供理论依据。方法:通过检索Science-Direct、PubMed、Cochrane Library、中国生物医学文献数据库（CMB）、相关期刊论文(CNKI)、万方数据库等国内外的文献资料库，搜集2000年1月1日至2014年6月30日关于外科手术对前交通动脉瘤的病例对照文献，并补充检索纳入研究的参考文献，，仔细分析文献，根据相关标准纳入和排除文献、整理信息资料并使用Cochrane对资料进行质量评价，使用ＲevMan5．1软件对文献中手术治疗方式及治疗效果、并发症等相关结果进行Meta分析。结果:系统分析资料后，有12篇回顾性分析文献共9955名诊断明确的前交通动脉瘤患者纳入研究，在这些患者中有4855名进行了介入栓塞手术治疗，有5100名进行了开颅显微手术夹闭治疗。Meta分析结果显示:介入栓塞术较开颅显微夹闭后住院时间短（P=0.005）、电解质紊乱发生率低（P=0.02），差异具有统计学意义，而在脑积水、血管痉挛、再出血、致残率等方面无统计学意义(均P0.05)，栓塞患者复发率稍高(P0.01)，差异具有统计学意义。结论:介入栓塞具有不需开颅、对脑组织副损伤小、住院时间短、术后恢复快、电解质紊乱发生率低等优势。前交通动脉瘤栓塞与夹闭在再出血、脑积水、脑血管痉挛、致残率等方面无差异，但动脉瘤复发率高。前交通动脉瘤治疗建议首选介入栓塞，但要求临床医师具有丰富的经验、精湛的技术及先进的设备，达到致密栓塞动脉瘤，降低复发率。
[Abstract]:Objective: to explore the best operation method of anterior communicating aneurysm and to provide theoretical basis for the treatment of anterior communicating artery aneurysm. Methods: by searching Science-Direct,PubMed,Cochrane Library, Chinese biomedical literature database (CMB), Chinese periodical full-text database (CNKI), Wanfang database and other domestic and foreign literature databases. To collect the case-control literature on surgical treatment of anterior communicating aneurysms from January 1, 2000 to June 30, 2014, and to supplement and retrieve the references that were included in the study, to analyze the literature carefully, and to include and exclude the literature according to the relevant standards, The quality of the data was evaluated by Cochrane, and the results of surgical treatment and treatment, complications and other related results were analyzed by Meta using RevMan5.1 software. Results: after systematic analysis, 9955 patients with clearly diagnosed anterior communicating aneurysms were included in the study, and 4855 of them underwent interventional embolization. The results of Meta analysis showed that the hospitalization time of interventional embolization was shorter than that of open microclipping (P0. 005), and the incidence of electrolyte disturbance was lower (P0. 02), the difference was statistically significant. There was no significant difference in hydrocephalus, vasospasm, rebleeding, disability rate (P0.05), the recurrence rate of embolism patients was higher (P0.01), the difference was statistically significant. Conclusion: interventional embolization has the advantages of no craniotomy, less injury to brain tissue, short hospitalization time, quick recovery after operation and low incidence of electrolyte disturbance. There was no difference between embolization and clipping of anterior communicating artery aneurysm in rebleeding, hydrocephalus, cerebral vasospasm and disability rate, but the recurrence rate of aneurysm was high. Interventional embolization is the first choice in the treatment of anterior communicating aneurysm, but the clinician is required to have rich experience, consummate technique and advanced equipment to embolize the aneurysm compactly and reduce the recurrence rate.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1

【参考文献】