【摘要】：目的:對(duì)腰大池持續(xù)引流同時(shí)聯(lián)合側(cè)腦室外引流治療腦室出血患者的治療有效性進(jìn)行合并研究,為以后腦室出血的患者提供更方便、更迅速、更具有針對(duì)性的治療方法。方法:利用電子計(jì)算機(jī),以腦室出血“Ventricular hemorrhage”;側(cè)腦室外引流“Latreral ventriecle drainage”;腰大池持續(xù)引流“In a large waist pool drainage”為檢索詞。檢索OVID、Pub Med、VIP、CBM、萬方數(shù)據(jù)庫、CNKI等中英文醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫,納入關(guān)于治療腦室出血的研究中使用腰大池持續(xù)引流同時(shí)聯(lián)合腦室外引流的全部隨機(jī)對(duì)照試驗(yàn)。結(jié)果:最終納入409例腦室出血患者,共涉及7個(gè)研究。Meta分析結(jié)果顯示:在治療有效率方面,常規(guī)組明顯低于聯(lián)合組,其差異有明顯的統(tǒng)計(jì)學(xué)意義[RR=1.86,95%CI(1.45,2.15),P0.00001];在結(jié)局指標(biāo)病死率方面,常規(guī)組明顯高于聯(lián)合組,兩組差異有統(tǒng)計(jì)學(xué)意義[RR=0.34,95%CI(0.20,0.58),P0.001];常規(guī)組的的血腫清除率明顯較聯(lián)合組的血腫清除率低,兩組差異有統(tǒng)計(jì)學(xué)意義[RR=1.56,95%CI(1.28,1.90),P0.001];常規(guī)組患者腦積水在隨訪結(jié)束時(shí)的發(fā)生情況明顯低于聯(lián)合組,兩組差異有統(tǒng)計(jì)學(xué)意義[RR=0.13,95%CI(0.04,0.70),P0.007]。由于對(duì)少部分患者的預(yù)后情況缺乏相關(guān)研究素材,暫時(shí)不能更加準(zhǔn)確的分析腰大池持續(xù)引流聯(lián)合側(cè)腦室外引流對(duì)治療腦室出血的影響。結(jié)論:腰大池持續(xù)引流同時(shí)結(jié)合側(cè)腦室外引流的外科治療方法,對(duì)于治療腦室出血易于操作,對(duì)患者損傷較小。雖從本文能看出使用側(cè)腦室外引流聯(lián)合能有效降低患者的病死率和腦積水的發(fā)生率,對(duì)提高患者的生存率及愈后的生活質(zhì)量有明顯作用,但更期待更加高質(zhì)量的臨床研究。
[Abstract]:Objective: to study the efficacy of continuous lumbar cistern drainage combined with lateral ventricular external drainage in the treatment of ventricular hemorrhage in order to provide a more convenient, rapid and targeted treatment for the patients with ventricular hemorrhage. Methods: the key words were "Ventricular hemorrhage" (ventricular hemorrhage), "Latreral ventriecle drainage" (lateral ventricular drainage) and "In a large waist pool drainage" (continuous drainage of lumbar cistern) by computer. To search the OVID,Pub Med,VIP,CBM, Wanfang database, CNKI and other Chinese and English medical literature databases, all the randomized controlled trials in which the lumbar cistern continuous drainage combined with ventricular drainage were used in the study on the treatment of ventricular hemorrhage were carried out. Results: a total of 7 studies were involved in the patients with ventricular hemorrhage. The results of Meta analysis showed that the effective rate of treatment in routine group was significantly lower than that in combined group. The difference was statistically significant [RR=1.86,95%CI (1.45m2.15), P0.00001]; The mortality of the outcome index in the routine group was significantly higher than that in the combined group, and the difference between the two groups was statistically significant [RR=0.34,95%CI (0.20 鹵0.58), P0.001]; The hematoma clearance rate of the routine group was significantly lower than that of the combined group, and the difference between the two groups was statistically significant [RR=1.56,95%CI (1.28 鹵1.90), P0.001]; The incidence of hydrocephalus in the routine group was significantly lower than that in the combined group at the end of follow-up. The difference between the two groups was statistically significant [RR=0.13,95%CI (0.04 鹵0.70), P 0.007]. Due to the lack of relevant research materials for the prognosis of a few patients, it is not possible to analyze more accurately the effect of continuous lumbar cistern drainage combined with lateral ventricular external drainage on the treatment of ventricular hemorrhage. Conclusion: the surgical treatment of continuous lumbar cistern drainage combined with lateral ventricular external drainage is easy to operate and less injuried to patients with ventricular hemorrhage. Although it can be seen from this paper that the use of lateral ventricular external drainage can effectively reduce the mortality and the incidence of hydrocephalus, and improve the survival rate and the quality of life of the patients, it is expected to have a higher quality of clinical research.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R651.1

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