颅内动脉瘤破裂急性期治疗方案的Meta-分析

发布时间：2019-04-13 13:39

【摘要】：目的:用Meta分析的方法探讨开颅手术治疗与介入治疗颅内动脉瘤破裂急性期疗效及安全性。方法:在循证医学的基础上,用计算机和手工检索,收集从建库到现在所发表的,两种办法治疗脑动脉瘤破裂出血急性期内的研究,应用软件对研究进行Meta分析,得出结论。结果:通过对各个数据库的仔细检索、全面筛选,我们一共选择11个已经公开发表的文献,进行我们的研究,共计2495例患者,其中外科手术夹闭组1363例,血管内治疗介入组1132例,并进行相关数据的Meta分析。分析结果显示:(1)两组术后1年不良预后对比差异有统计学意义;(2)两组术后完全闭塞率差异有统计学意义;(3)两组术后脑血管痉挛还有脑积水的方面差异无统计学意义。结论:研究显示:(1)比较两组患者12个月后的预后,血管组的病人不良预后优于夹闭组。(2)开颅显微手术夹闭组的动脉瘤的完全闭塞率优于血管组。(3)开颅显微手术夹闭组的患者术后脑积水以及脑血管痉挛的发生率无明显差异。(4)由于我们本次研究选择的文献并不全部是RCT,也有一部分的回顾性分析,所以,可能有偏倚存在,但我们用漏斗图来评价偏倚。
[Abstract]:Objective: to evaluate the efficacy and safety of craniotomy and interventional therapy for intracranial aneurysm rupture in acute stage by Meta analysis. Methods: on the basis of evidence-based medicine, computer and manual retrieval were used to collect the two methods of treating the acute period of ruptured hemorrhage of cerebral aneurysm from the establishment of the database to the present published. Meta analysis of the study was carried out with software, and the conclusion was drawn. Results: through careful search and comprehensive screening of various databases, we selected 11 published documents and carried out our study. There were 2495 patients, including 1363 patients in the surgical closure group. 1132 patients in the interventional group were treated by intravascular therapy, and the data were analyzed by Meta. The results showed that: (1) there was a significant difference in the adverse prognosis between the two groups in one year after operation; (2) there was a significant difference in the complete occlusive rate between the two groups; (3) there was no significant difference in cerebral vasospasm and hydrocephalus between the two groups. Conclusion: the study showed: (1) comparing the prognosis of the two groups after 12 months, (2) the complete occlusion rate of aneurysms in the craniotomy microsurgery group was better than that in the vascular group. (3) hydrocephalus and cerebral vasospasm after operation in the craniotomy microsurgical clamping group were better than those in the vascular group. There was no significant difference in the incidence of contracture. (4) because not all of the literatures we chose in this study were RCT,. There is also a partial retrospective analysis, so there may be bias, but we use the funnel diagram to evaluate bias.
【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

【引证文献】