摘要
目的评价颅内血肿微创清除术和内科保守治疗自发性脑出血在提高患者日常生活能力及其存活率方面的疗效。方法根据预定的纳入、排除标准,在中国知网、万方数据库、维普资讯网数据库及Pubmed进行相关检索。用Revman5软件对数据进行整理和分析。对于单变量计数资料用优势比(OR)及其95%可信区间(95%CI)表示。对资料进行异质性检验,以判断多个研究结果的总体效应是否一致,若一致,则采用固定效应模型;反之,则用随机效应模型。对某些可能影响结果的重要因素进行敏感性分析,从而判断结果的稳定性和证据力度。结果共检索出2008～2011年已发表符合要求的13篇RCT,包括1374例患者。Meta分析显示,颅内血肿微创清除术与内科保守治疗在脑出血治疗上的存活率方面差异具有统计学意义(OR=4.12,95%CI2.85～5.95,P<0.01);颅内血肿微创清除术与内科保守治疗在脑出血治疗上的显效率方面差异具有统计学意义(OR=4.24,95%CI2.84～6.31,P<0.01);颅内血肿微创清除术与内科保守治疗在脑出血治疗上的有效率方面差异无统计学意义(OR=1.39,95%CI0.83～2.31,P>0.01)。结论脑出血后采用颅内血肿微创清除术可提高患者存活率和日常生活能力。
Objective To assess the effect of microinvasive scavenging technique and conservative treatment in patients with spontaneous intracerebral hemorrhage in improving viability and survival rate.Methods According to predetermined criteria of inclusion and exclusion,a search was performed in databases of CNKI,Wanfang and Weipu during 2008-2011.A supplementary PUBMED search was performed.Data synthesis and analysis was performed with the Cochrane Review Manager software（RevMan version 5）.The results were expressed as Odds Ratio（OR） and 95% confidence interval（CI）.Data was pulled using fixed effect model or random effect model according to their homogeneity or heterogeneity.If the overall effect of search result is consistent,we use the fixed effect model.On the contrary,the random effect model would be selected.Sensitivity analysis would be undertaken of certain important factors which may affect the outcome,in order to determine the stability of the result and the strength of the evidence.Results Twelve randomized studies on this topic were evaluated.Among these 13 studies,1374 patients were included.The survival rate under microinvasive scavenging technique or conservative treatment was significantly different（OR=4.12,95%CI 2.85～5.95,P0.01）.The significantly effective rate of microinvasive scavenging technique or conservative treatment was significantly different（OR=4.24,95%CI 2.84～6.31,P0.01）.The effective rate of microinvasive scavenging technique or conservative treatment was not significantly different（OR=1.39,95%CI 0.83～2.31,P0.01）.Conclusions Minimally invasive surgery can improve patients＇ survival and daily living in cerebral hemorrhage.
出处
《卒中与神经疾病》
2012年第2期104-108,共5页
Stroke and Nervous Diseases
关键词
颅内血肿微创清除术
脑出血
META分析
Microinvasive scavenging technique Intracranial hematoma（ICH） Meta-analysis
