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立体定向软通道颅内血肿清除术与内科保守治疗高血压性脑出血疗效的Meta分析

孟曙庆 张洪 黎黎

中国卒中杂志Issue(2):106-116,11.
中国卒中杂志Issue(2):106-116,11.DOI:10.3969/j.issn.1673-5765.2014.02.005

立体定向软通道颅内血肿清除术与内科保守治疗高血压性脑出血疗效的Meta分析

Efficacy of Stereotactic Catheter Indwelt Hematoma Aspiration in Patients with Hypertensive Intracerebral Hemorrhage:Meta-analysis

孟曙庆 1张洪 1黎黎1

作者信息

  • 1. 430071 武汉武汉大学中南医院神经内科
  • 折叠

摘要

Abstract

Objective To evaluate stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage. <br> Methods Cochrane database of systematic review (CENTRAL), MEDLINE, Excerpta Medica Database (EMbase), Physiotherapy Evidence Database, Open System for Information on Grey Literature in Europe (OpenSIGLE), National Technical Information Service (NTIS), China National Knowledge Infrastructure (CNKI), VIP, Wanfang data, and China Biology Medicine disc (CBMdisc) were searched for the randomized controlled trials (RCTs) of stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage from the data of establishment of the databases to December 2012. The bibliographies of included studies were searched, too. Two researchers evaluated the included studies using grading of recommendations assessment, development and evaluation (GRADE). The extract data were analyzed by RevMan 5.2 and GRADE proifler 4.0.3. <br> Results A total of 11 trials were discovered. Meta-analysis showed that there were significant differences in clinical beneift, fatality rate, infection, and rebleeding in stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage compared with initial conservative treatment (odds ratio [OR] 3.34, 95%conifdence interval [CI] 2.13 to 5.22;OR 0.42, 95%CI 0.29 to 0.60;OR 0.42, 95%CI 0.27 to 0.64;and OR 0.47, 95%CI 0.28 to 0.77). The four outcomes were all of low quality in the GRADE system. <br> Conclusion The current evidence shows stereotactic catheter indwelt hematoma aspiration in patients with hypertensive intracerebral hemorrhage was effective whereas reduction in the numbers of fatality rate, infection and rebleeding and increase at clinical benefit at the end of 3 months, compared with initial conservative treatment. The clinician should recommend it for its simplicity, low input costs, low operating costs and fewer side effects. Due to the limitations of the included studies, more large-sample, high-quality RCTs are required.

关键词

高血压性脑出血/立体定向血肿清除术/疗效/感染/再出血/病死率/Meta分析

Key words

Hypertensive intracerebral hemorrhage/Stereotactic aspiration/Efifcacy/Infection/Rebleeding/Fatality rate/Meta-analysis

引用本文复制引用

孟曙庆,张洪,黎黎..立体定向软通道颅内血肿清除术与内科保守治疗高血压性脑出血疗效的Meta分析[J].中国卒中杂志,2014,(2):106-116,11.

中国卒中杂志

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1673-5765

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