摘要
目的系统评价侧脑室外引流联合腰大池引流治疗脑室出血患者的有效性,为今后脑室出血的患者提供更好的治疗方法。方法利用计算机检索OVID循证医学数据库、Pub Med生物医学文献检索系统、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)、中国知网(CNKI)、万方数据库等中文数据库,纳入脑室外引流联合腰大池引流治疗脑室出血患者的随机对照试验。结果最终纳入7个研究,共409例脑室出血患者。Meta分析结果显示:联合组的治疗有效率明显高于常规组,其差异有统计学意义[相对危险度(RR)=1.75,95%可信区间(CI)(1.45,2.15),P<0.01];联合组病死率明显低于常规组,2组差异有统计学意义[RR=0.34,95%CI(0.20,0.58),P<0.01];联合组血肿清除率明显高于常规组,2组差异有统计学意义[RR=1.56,95%CI(1.28,1.90),P<0.01];联合组脑积水发生率明显低于常规组,2组差异有统计学意义[RR=0.13,95%CI(0.04,0.42),P<0.01]。对于短期临床预后与随访远期预后情况缺乏相关资料,暂时不能准确分析侧脑室外引流联合腰大池引流对脑室出血的影响。结论侧脑室外引流并腰大池引流方法简单方便、易于操作,能有效降低患者病死率、脑积水发生率,提高生存率及患者预后的生活质量,但更期待更加高质量的临床研究。
Objective To systemically evaluate the effect of external ventricular drainage combined with lum-bar cistern drainage in the treatment of intraventricular hemorrhage （IVH）, and to provide a better treatment option for IVH patients. Methods Systematic literature retrieval was carried out from Evidence-based Medicine Reviews （OVID）, PubMed Biomedical Literature Analysis ＆amp; Retrieval System, China Biology Medicine disc （CBM）, Vip Database of Chinese Science ＆amp; Technology Periodicals （VIP）, China National Knowledge Internet （CNKI） and Wan-fang Database, which included the randomized controlled trial of external ventricular drainage combined with lumbar cistern drainage in the treatment of IVH. Results Seven studies with 409 IVH patients were eventually included. Meta-analysis showed that the effective rate in the combination treatment group was significantly higher than that in the conventional treatment group, with statistically significant difference [ RR=1.75, 95%CI （1.45, 2.15）, P〈0.01]; the mortality in the combination treatment group was significantly lower than that in the conventional treatment group, with statistically significant difference [RR=0.34, 95%CI （0.20, 0.58）, P〈0.01]; the hematoma clearance rate in the combination treatment group was significantly higher than that in the conventional treatment group, with statistically significant difference [RR=1.56, 95%CI（1.28, 1.90）, P〈0.01];the incidence of hydrocephalus in the combination treat-ment group was significantly lower than that in the conventional treatment group, with statistically significant differ-ence [RR=0.13, 95%CI（0.04, 0.42）, P〈0.01]. Lacking relevant data for the short-term clinical prognosis and long-term outcomes in follow-up, the accurate effect of external ventricular drainage combined with lumbar cistern drainage on IVH could not be accurately analyzed at this time. Conclusion External ventricular drainage combined with lumbar cistern drainage is simple, convenient and operativel
出处
《中国药物与临床》
CAS
2015年第5期598-602,共5页
Chinese Remedies & Clinics
基金
国家自然科学基金(3060063)
山西省归国留学基金(2011-096)
山西省基础研究计划(2010021034-4)
山西医科大学科技创新项目(201201010)
关键词
脑出血
META分析
引流术
Cerebral hemorrhage
Meta-analysis
Drainage
