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中华卫生应急电子杂志 ›› 2024, Vol. 10 ›› Issue (02) : 65 -69. doi: 10.3877/cma.j.issn.2095-9133.2024.02.001

论著

比较神经内镜与钻孔引流对慢性硬膜下血肿疗效的Meta分析
王学建1,(), 汪志峰1, 钱明1, 姜雷1, 宋校伟1, 胡伟梁1   
  1. 1. 226001 江苏南通,江苏省南通市第一人民医院神经外科
  • 收稿日期:2024-03-03 出版日期:2024-04-18
  • 通信作者: 王学建
  • 基金资助:
    南通市医学重点人才基金项目(重点03); 南通市卫健委科技发展计划项目(MA2019003,MA2021017); 南京医科大学康达学院科研项目(KD2021JYYJYB025,KD2022KYJJZD022)

Comparison of efficacies between neuroendoscopy and trepanation and drainage on chronic subdural hematoma: a meta-analysis

Xuejian Wang1,(), Zhifeng Wang1, Ming Qian1, Lei Jiang1, Xiaowei Song1, Weiliang Hu1   

  1. 1. Department of Neurosurgery, Nantong First People's Hospital, Nantong 226001, China
  • Received:2024-03-03 Published:2024-04-18
  • Corresponding author: Xuejian Wang
引用本文:

王学建, 汪志峰, 钱明, 姜雷, 宋校伟, 胡伟梁. 比较神经内镜与钻孔引流对慢性硬膜下血肿疗效的Meta分析[J/OL]. 中华卫生应急电子杂志, 2024, 10(02): 65-69.

Xuejian Wang, Zhifeng Wang, Ming Qian, Lei Jiang, Xiaowei Song, Weiliang Hu. Comparison of efficacies between neuroendoscopy and trepanation and drainage on chronic subdural hematoma: a meta-analysis[J/OL]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2024, 10(02): 65-69.

目的

比较神经内镜与钻孔引流两种手术方式治疗慢性硬膜下血肿的安全性和有效性。

方法

运用维普、CNKI、万方三个数据库,检索自1990年3月至2023年2月使用神经内镜技术与单纯钻孔引流治疗慢性硬膜下血肿的RCT研究。对符合纳入标准的文献采用RevMan5.3软件进行Meta分析。

结果

本研究纳入6项研究,共599例患者。Meta分析提示神经内镜组在住院时间、术后复发及术后并发症较单纯钻孔引流治疗慢性硬膜下血肿存在明显优势,手术时间较对照组长,两种治疗方式存在差异,且差异有统计学意义(P<0.01)。OR合并值(95%CI)分别为14.93(13.35~16.51)、-1.69(-1.85~-1.54)、0.19(0.09~0.37)、0.19(0.10~0.38),差异均有统计学意义(P<0.05)。

结论

对于慢性硬膜下血肿,采用神经内镜与单纯钻孔引流治疗,两者相比,神经内镜技术除手术时间稍长外,其住院时间短,术后复发及并发症明显少,所以神经内镜技术的安全性及有效性确切,值得推广运用。

Objective

To compare the safety and efficacy of neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma by meta-analysis.

Methods

From March 1990 to February 2023, the three databases of Cqvip, CNKI and Wanfang were searched to find out the RCT studies and to compare the neuroendoscopy treatment of chronic subdural hematoma with trephorization alone. Using three databases (Cqvip, CNKI and Wanfang), the RCT studies comparing with neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma from March 1990 to February 2023 were obtained. RevMan5.3 software was used for meta-analysis of the selected literatures that met the inclusion criteria.

Results

A total of 599 patients were enrolled in 6 studies. Meta-analysis suggested that the neuroendoscopy group had obvious advantages over the control group in terms of length of stay, postoperative recurrence and postoperative complications, and the operation time was longer than that of the control group. There were statistically significant differences between the two treatment modalities (P<0.01). The combined value of OR (95% CI) was 14.93 (13.35~16.51), -1.69 (-1.85~-1.54), 0.19 (0.09~0.37), and 0.19 (0.10~0.38), respectively and the differences were statistically significant (P<0.05).

Conclusion

For chronic subdural hematoma, compared with simple burr hole drainage, neuroendoscopy has a slightly longer operation time, a shorter hospital stay, and significantly fewer postoperative recurrence and complications. Therefore, the safety and effectiveness of neuroendoscopy are accurate, worthy of promotion and application.

图1 文献检索流程
图2 两组患者手术时间比较
图3 两组患者住院时间
图4 两组患者术后复发
图5 并发症发生情况
图6 发表偏倚注:图中的圈代表纳入的研究
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