| 动脉瘤性SAH手术夹闭与介入栓塞疗效及并发症的Meta分析 |
| 投稿时间：2016-03-29 修订日期：2016-04-19 点此下载全文 |
| 引用本文：张文凯,刘绍明.动脉瘤性SAH手术夹闭与介入栓塞疗效及并发症的Meta分析[J].医学研究杂志,2016,45(11):136-141 |
| DOI：
10.11969/j.issn.1673-548X.2016.11.035 |
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| 中文摘要:目的 评价动脉瘤性蛛网膜下腔出血后经不同术式治疗的患者其预后及术后并发症发生率有无统计学差异。方法 在Medline、Embase、Cochrane等文献数据库中对近20年内发表的关于手术夹闭及介入栓塞治疗颅内破裂动脉瘤的对比研究进行检索。由2名评价者独立的筛选出符合纳入标准的文献，并用Review Manager 5.3软件进行Meta分析。结果 共纳入11篇文献，合计4970例患者。比较两种术式术后脑血管痉挛、脑积液的发生率，经Meta分析，其OR值（95% CI）分别为1.23（0.77~1.95）、0.90（0.70~1.15），差异均无统计学意义（P>0.05）。固定效应模型分析术后不良预后的发生率OR值（95% CI）为1.38（1.15~1.66），差异有统计学意义（P<0.05）；随机效应模型分析术后不良预后的发生率OR值（95% CI）为1.33（0.91~1.96），差异无统计学意义（P>0.05）。结论 接受不同术式治疗的动脉瘤破裂患者，其术后脑血管痉挛、脑积液的发生率没统计学差异；不能说明开颅夹闭术后患者不良预后的发生率高于接受介入栓塞治疗的患者。 |
| 中文关键词:动脉瘤 蛛网膜下腔出血 手术夹闭 介入栓塞 Meta分析 |
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| Neurosurgical Clipping Versus Endovascular Coiling for Aneurysmal Subarachnoid Hemorrhage: A Meta-analysis About the Outcomes |
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| Abstract:Objective To determine whether the outcomes and complications of the patients suffering from aneurysmal subarachnoid hemorrhage(SAH) differs when comparing surgical clip application with endovascular obliteration of ruptured intracranial aneurysms. Methods We conducted a meta-analysis of studies that compared clipping with coiling between January 1996 and March 2016.Comparison of binary outcomes between treatment groups was described using odds ratios(OR,clip versus coil). Results One randomized controlled trials and ten observational studies were included.Vsaospasm (OR=1.23,95% CI:0.77-1.95,P>0.05),shunt-dependent hydrocephalus (OR=0.90,95% CI:0.70-1.15, P>0.05),rates did not differ significantly between different techniques.Unfavorable outcomes rate showed difference on fixed-effects model(OR 1.38,95% CI:1.15-1.66,P<0.05) but made no difference when random-effects model(OR=1.33, 95% CI:0.91-1.96,P>0.05) was used. Conclusion The treatment method used for ruptured intracranial aneyrysms,i.e.,neurosurgical clipping or endovascular coiling,has no statistically significant effect on the development of vasospasm,shunt-dependent hydrocephalus and unfavorable outcomes rates. |
| keywords:Aneurysm Subarachnoid hemorrhage(SAH) Clip Coil Meta-analysis |
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