第三脑室底造瘘术和脑室-腹腔分流术治疗非交通性脑积水的Meta分析  

Meta analysis of endoscopic third ventriculostomy and ventriculo-peritoneal shunt for treating non-communicating hydrocephalus

作　　者：刘欣[1] 王茂德[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,710061

出　　处：《中国微侵袭神经外科杂志》2012年第1期9-13,共5页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的通过Meta分析对神经内镜下第三脑室底造瘘术(ETV)和脑室-腹腔(V-P)分流术治疗非交通性脑积水的疗效进行综合分析。方法通过计算机检索PubMed、EMBASE、Ovid、ScienceDirec、SpringerLink、中国知网数据库、万方、维普及中国生物医学文献数据库,查出2000-2010年发表的有关ETV和V-P分流术治疗非交通性脑积水的相关文献,选择RevMan5.0软件以固定效应模型进行Meta分析。结果纳入9项临床对照研究。Meta分析结果显示:与V-P分流术相比,ETV术后症状缓解率、颅内血肿形成率差异无统计学意义(P>0.01),而ETV术后并发症发生率及复发率均明显低于V-P分流术(P<0.01)。结论 ETV和V-P分流术疗效相当,但ETV术后并发症发生率和复发率较低。Objective To systematically evaluate the efficacy of endoscopic third ventriculostomy （ETV） and ventriculo-peritonea （V-P） shunt for treating non-communicating hydrocephalus via Meta analysis. Methods The literatures about the comparative studies of ETV and V-P shunt for treating non-communicating hydrocephalus were collected from Pubmed, EMBASE, Ovid, ScienaceDirect, Springerlink, CNKI, Wanfang databases, Weipu databases, CBMdisc databases and manual retrieval from 2000 to 2010. RevMan5.0 software was used for data analysis. Results Nine literatures were selected finally. The comprehensive results of Meta analysis showed as follows： there was no statistical significance in the difference of symptom relief rate and intracranial hematoma rate between V-P shunt and ETV （P〉0.01）. While the difference in the complication rates and recurrence rate between V-P shunt and ETV reached statistical significance （P〈0.01）. Conclusions ETV and V-P shunt have therapeutic equivalence for obstructive hydrocephalus, whereas ETV can result in lower incidence of postoperative complication and recurrence rate of hydrocephalus.

关 键 词：脑积水 脑室造口术 脑室腹膜分流术 神经内镜 META分析 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]