發(fā)布時(shí)間：2018-03-24 14:42

  本文選題：動(dòng)脈瘤　切入點(diǎn)：蛛網(wǎng)膜下腔出血　出處：《醫(yī)學(xué)研究雜志》2016年11期

【摘要】：目的評(píng)價(jià)動(dòng)脈瘤性蛛網(wǎng)膜下腔出血后經(jīng)不同術(shù)式治療的患者其預(yù)后及術(shù)后并發(fā)癥發(fā)生率有無統(tǒng)計(jì)學(xué)差異。方法在Medline、Embase、Cochrane等文獻(xiàn)數(shù)據(jù)庫(kù)中對(duì)近20年內(nèi)發(fā)表的關(guān)于手術(shù)夾閉及介入栓塞治療顱內(nèi)破裂動(dòng)脈瘤的對(duì)比研究進(jìn)行檢索。由2名評(píng)價(jià)者獨(dú)立的篩選出符合納入標(biāo)準(zhǔn)的文獻(xiàn),并用Review Manager 5.3軟件進(jìn)行Meta分析。結(jié)果共納入11篇文獻(xiàn),合計(jì)4970例患者。比較兩種術(shù)式術(shù)后腦血管痙攣、腦積液的發(fā)生率,經(jīng)Meta分析,其OR值(95%CI)分別為1.23(0.77~1.95)、0.90(0.70~1.15),差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。固定效應(yīng)模型分析術(shù)后不良預(yù)后的發(fā)生率OR值(95%CI)為1.38(1.15~1.66),差異有統(tǒng)計(jì)學(xué)意義(P0.05);隨機(jī)效應(yīng)模型分析術(shù)后不良預(yù)后的發(fā)生率OR值(95%CI)為1.33(0.91~1.96),差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論接受不同術(shù)式治療的動(dòng)脈瘤破裂患者,其術(shù)后腦血管痙攣、腦積液的發(fā)生率沒統(tǒng)計(jì)學(xué)差異;不能說明開顱夾閉術(shù)后患者不良預(yù)后的發(fā)生率高于接受介入栓塞治療的患者。
[Abstract]:Objective to evaluate the prognostic and postoperative complications of patients with aneurysm subarachnoid hemorrhage (SAH) treated with different surgical methods. Methods the surgical clips published in Medlinea Embase Cochrane and other literature databases in recent 20 years were reviewed. A comparative study of closed and interventional embolization in the treatment of ruptured intracranial aneurysms was carried out. Documents that met the inclusion criteria were independently screened by two evaluators. Meta analysis was carried out with Review Manager 5.3 software. Results 4970 patients were included in 11 literatures. The incidence of cerebral vasospasm and cerebral effusion were analyzed by Meta. The odds ratio (OR) was 1.23 / 0.77 / 1.95 / 0.90 / 0.701.15, respectively, with no significant difference (P 0.05). The OR value of fixed effect model (95 CI) was 1.381.151.66 (P 0.05), and the OR value of random effect model was 0.701.15 (P < 0.05), and the OR value of random effect model was significant (P < 0.05) in the analysis of adverse prognosis after operation (P < 0.05). The odds ratio (OR) of fixed effect model in the analysis of postoperative adverse prognosis was 1.38 鹵1.151.66 (P < 0.05). The CII was 1.33 / 0.91 / 1.96, with no significant difference (P 0.05). Conclusion the patients with ruptured aneurysms received different surgical procedures, The incidence of cerebral vasospasm and cerebral effusion was not significantly different after operation, which could not indicate that the incidence of poor prognosis after craniotomy was higher than that of patients receiving interventional embolization.
【作者單位】： 石河子大學(xué)醫(yī)學(xué)院;中國(guó)人民解放軍蘭州軍區(qū)烏魯木齊總醫(yī)院神經(jīng)外科;
【分類號(hào)】：R651.1

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