临床神经外科杂志2019，Vol.16Issue(6)：500-506,7.DOI:10.3969/j.issn.1672-7770.2019.06.009
神经内镜对比脑室外引流治疗脑室出血的荟萃分析
Meta-analysis of neuroendoscopy versus external ventricular drainage in treatment of intraventricular hemorrhage
摘要
Abstract
Objective The effectiveness and safety of neuroendoscopy ( NE) versus external ventricular drainage ( EVD ) in the treatment of intraventricular hemorrhage was systematically evaluated, which provided a basis for clinical work.Methods The relevant search terms were used to search randomized and non-randomized controlled studies in Chinese and English databases (including CNKI, Wanfang, VIP, the Cochrane Library, PubMed, EMbase ).The data was combined and analyzed using RevMan 5.3 software.Subgroup analysis was performed on the type of design, follow-up time, and preoperative time.Results A total of 19 articles(1 269 patients) were included (9 randomized controlled trials and 10 non-randomized controlled trials ).Meta-analysis showed that NE group could increase the effective hematoma clearance rate (OR＝22.30, 95%CI:14.35-34.64,P＜0.000 01), improve the good functional outcome ( OR＝3.07,95%CI:2.26-4.17,P＜0.000 01) and reduce patient mortality (OR＝0.48,95%CI:0.32-0.71,P＝0.000 3) significantly when compared with EVD group.In terms of complication incidence , the intracranial infection rate( OR ＝0.19, 95% CI:0.09 -0.43, P ＜0.000 1 ), postoperative rebleeding rate (OR＝0.22,95% CI:0.08-0.65,P＝0.006) and the incidence of hydrocephalus ( OR＝0.16, 95%CI:0.11 to 0.25,P＜0.000 01) in the NE group were significantly lower than that in the EVD group.Subgroup analysis showed follow-up time, preoperative time, and use of urokinase may be important factors influencing patients’mortality.Conclusion NE may be safer and more effective in treating ventricular hemorrhage than EVD.关键词
神经内镜/脑室出血/脑室外引流/Meta分析Key words
neuroendoscopy/external ventricular drainage/intraventricular hemorrhage/meta-analysis分类
医药卫生引用本文复制引用
李强,施炜,张恒柱,李育平,顾建华,白吉南,葛爱亮,杨德福..神经内镜对比脑室外引流治疗脑室出血的荟萃分析[J].临床神经外科杂志,2019,16(6):500-506,7.基金项目
江苏省卫生健康委科研课题(H2018064) （H2018064）
2018年度扬州市科技发展计划项目(YZ2018088 ) （YZ2018088 ）
