【摘要】：目的:用Meta分析的方法探討開顱手術(shù)治療與介入治療顱內(nèi)動(dòng)脈瘤破裂急性期療效及安全性。方法:在循證醫(yī)學(xué)的基礎(chǔ)上,用計(jì)算機(jī)和手工檢索,收集從建庫(kù)到現(xiàn)在所發(fā)表的,兩種辦法治療腦動(dòng)脈瘤破裂出血急性期內(nèi)的研究,應(yīng)用軟件對(duì)研究進(jìn)行Meta分析,得出結(jié)論。結(jié)果:通過(guò)對(duì)各個(gè)數(shù)據(jù)庫(kù)的仔細(xì)檢索、全面篩選,我們一共選擇11個(gè)已經(jīng)公開發(fā)表的文獻(xiàn),進(jìn)行我們的研究,共計(jì)2495例患者,其中外科手術(shù)夾閉組1363例,血管內(nèi)治療介入組1132例,并進(jìn)行相關(guān)數(shù)據(jù)的Meta分析。分析結(jié)果顯示:(1)兩組術(shù)后1年不良預(yù)后對(duì)比差異有統(tǒng)計(jì)學(xué)意義;(2)兩組術(shù)后完全閉塞率差異有統(tǒng)計(jì)學(xué)意義;(3)兩組術(shù)后腦血管痙攣還有腦積水的方面差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:研究顯示:(1)比較兩組患者12個(gè)月后的預(yù)后,血管組的病人不良預(yù)后優(yōu)于夾閉組。(2)開顱顯微手術(shù)夾閉組的動(dòng)脈瘤的完全閉塞率優(yōu)于血管組。(3)開顱顯微手術(shù)夾閉組的患者術(shù)后腦積水以及腦血管痙攣的發(fā)生率無(wú)明顯差異。(4)由于我們本次研究選擇的文獻(xiàn)并不全部是RCT,也有一部分的回顧性分析,所以,可能有偏倚存在,但我們用漏斗圖來(lái)評(píng)價(jià)偏倚。
[Abstract]:Objective: to evaluate the efficacy and safety of craniotomy and interventional therapy for intracranial aneurysm rupture in acute stage by Meta analysis. Methods: on the basis of evidence-based medicine, computer and manual retrieval were used to collect the two methods of treating the acute period of ruptured hemorrhage of cerebral aneurysm from the establishment of the database to the present published. Meta analysis of the study was carried out with software, and the conclusion was drawn. Results: through careful search and comprehensive screening of various databases, we selected 11 published documents and carried out our study. There were 2495 patients, including 1363 patients in the surgical closure group. 1132 patients in the interventional group were treated by intravascular therapy, and the data were analyzed by Meta. The results showed that: (1) there was a significant difference in the adverse prognosis between the two groups in one year after operation; (2) there was a significant difference in the complete occlusive rate between the two groups; (3) there was no significant difference in cerebral vasospasm and hydrocephalus between the two groups. Conclusion: the study showed: (1) comparing the prognosis of the two groups after 12 months, (2) the complete occlusion rate of aneurysms in the craniotomy microsurgery group was better than that in the vascular group. (3) hydrocephalus and cerebral vasospasm after operation in the craniotomy microsurgical clamping group were better than those in the vascular group. There was no significant difference in the incidence of contracture. (4) because not all of the literatures we chose in this study were RCT,. There is also a partial retrospective analysis, so there may be bias, but we use the funnel diagram to evaluate bias.
【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

【引證文獻(xiàn)】

相關(guān)會(huì)議論文 前1條

1 方兵;王義榮;孫偉軍;楊樹旭;陳毅力;牛煥江;李新偉;亓旭晨;馬力;朱先理;張鴻祺;;載瘤動(dòng)脈閉塞治療難治性顱內(nèi)動(dòng)脈瘤[A];2011年浙江省神經(jīng)外科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2011年

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本文編號(hào)：2457617