Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies ha...Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies have shown that timely clearance of intraventricular hematoma is closely related to good prognosis.The advantages of surgical intervention in patient management are impressive.This article briefly reviews the positive advances in the surgical treatment of IVH such as external ventricular drainage(EVD)combined with intraventricular fibrinolysis(IVF)and continuous lumbar cistern drainage(LCD),as well as their safety and efficacy,especially the remarkable role of neuroendoscopy in the removal of intraventricular hematomas.展开更多
目的评价腰大池持续引流治疗外伤性蛛网膜下腔出血的疗效与安全性。方法利用Rev Man 5.2软件对纳入所有应用腰大池持续引流治疗外伤性蛛网膜下腔出血的随机对照试验(RCT)进行系统评价。结果 23个RCT(2401例)符合纳入标准。根据治疗方法...目的评价腰大池持续引流治疗外伤性蛛网膜下腔出血的疗效与安全性。方法利用Rev Man 5.2软件对纳入所有应用腰大池持续引流治疗外伤性蛛网膜下腔出血的随机对照试验(RCT)进行系统评价。结果 23个RCT(2401例)符合纳入标准。根据治疗方法的不同分为两类,一类为腰大池持续引流组与一般治疗组,纳入5个RCT(470例),Meta分析显示,腰大池持续引流组的远期疗效(GOS评分良好率)明显高于一般治疗组[RR=1.17,95%CI(1.09,1.26)];与一般治疗组相比,总病死率减低[RR=0.20,95%CI(0.05,0.76)];并发症发生率包括脑积水[RR=0.23,95%CI(0.12,0.45)]和脑血管痉挛[RR=0.28,95%CI(0.16,0.48)]减低,。另一类为腰大池持续引流组与腰穿组,纳入18个RCT(1931例),Meta分析显示,腰大池持续引流组的远期疗效(GOS评分良好率)明显高于腰穿组[RR=1.26,95%CI(1.15,1.38)];总病死率减低[RR=0.37,95%CI(0.25,0.53)];并发症发生率包括脑积水[RR=0.24,95%CI(0.17,0.34)]、脑血管痉挛[RR=0.31,95%CI(0.22,0.44)]和再出血[RR=0.41,95%CI(0.25,0.68)]减低。结论腰大池持续引流治疗外伤性蛛网膜下腔出血的疗效明显优于一般治疗及腰穿组。展开更多
文摘Intraventricular hemorrhage(IVH)is a dangerous acute cerebrovascular disease.The 30-day mortality rate of patients with IVH is 5 times that of patients with cerebral hemorrhage.In recent years,more and more studies have shown that timely clearance of intraventricular hematoma is closely related to good prognosis.The advantages of surgical intervention in patient management are impressive.This article briefly reviews the positive advances in the surgical treatment of IVH such as external ventricular drainage(EVD)combined with intraventricular fibrinolysis(IVF)and continuous lumbar cistern drainage(LCD),as well as their safety and efficacy,especially the remarkable role of neuroendoscopy in the removal of intraventricular hematomas.
文摘目的评价腰大池持续引流治疗外伤性蛛网膜下腔出血的疗效与安全性。方法利用Rev Man 5.2软件对纳入所有应用腰大池持续引流治疗外伤性蛛网膜下腔出血的随机对照试验(RCT)进行系统评价。结果 23个RCT(2401例)符合纳入标准。根据治疗方法的不同分为两类,一类为腰大池持续引流组与一般治疗组,纳入5个RCT(470例),Meta分析显示,腰大池持续引流组的远期疗效(GOS评分良好率)明显高于一般治疗组[RR=1.17,95%CI(1.09,1.26)];与一般治疗组相比,总病死率减低[RR=0.20,95%CI(0.05,0.76)];并发症发生率包括脑积水[RR=0.23,95%CI(0.12,0.45)]和脑血管痉挛[RR=0.28,95%CI(0.16,0.48)]减低,。另一类为腰大池持续引流组与腰穿组,纳入18个RCT(1931例),Meta分析显示,腰大池持续引流组的远期疗效(GOS评分良好率)明显高于腰穿组[RR=1.26,95%CI(1.15,1.38)];总病死率减低[RR=0.37,95%CI(0.25,0.53)];并发症发生率包括脑积水[RR=0.24,95%CI(0.17,0.34)]、脑血管痉挛[RR=0.31,95%CI(0.22,0.44)]和再出血[RR=0.41,95%CI(0.25,0.68)]减低。结论腰大池持续引流治疗外伤性蛛网膜下腔出血的疗效明显优于一般治疗及腰穿组。
