动脉瘤性蛛网膜下腔出血致迟发性脑血管痉挛危险因素的Meta分析  

A Meta-analysis of risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage

作　　者：吴政俊 蒋永祥[1] 程远[1] 马颖[1] 

机构地区：[1]重庆医科大学附属第二医院神经外科,400010

出　　处：《重庆医学》2014年第14期1718-1720,1723,共4页Chongqing medicine

摘　　要：目的运用Meta分析方法综合分析动脉瘤性蛛网膜下腔出血致迟发性脑血管痉挛(DCVS)的相关危险因素,为疾病的预防、治疗决策提供依据。方法用关键词途径从维普中文科技期刊、中国知网和万方以及Pubmed、Springlink和Highwire等外文数据库收录有关动脉瘤性蛛网膜下腔出血致DCVS相关危险因素的文献进行检索,经严格筛选后对最后纳入的文献用RevMan5.1软件进行Meta分析。结果共纳入13篇文献,经检验所有数据均均衡,采用固定效应模式进行Meta分析。高血压病史、Fisher分级(>2级)、年龄(>50岁)、动脉瘤位置(后循环)差异有统计学意义(P<0.05),性别(男性)、吸烟史、手术方式(夹闭)差异无统计学意义(P>0.05)。数据漏斗图分析对称,提示文献无发表偏倚。结论有高血压病史、Fisher分级(>2级)、年龄(<50岁)、动脉瘤位置(后循环)的患者更易发生DCVS,临床上应对此类患者加强监测与管理。Objective To systematically analyze the risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage in order to provide evidence for prevention and treatment of the disease .Methods Articles of risk factors for de1ayed cerebral vasospasm after aneurysm subarachnoid hemorrhage from VIP ,CBM ,CNKI ,Wangfang and pubmed ,springlink ,highwire database ,and correlated indexes were extracted for Meta‐analysis by using RevMan 5 .1 .Results Thirteen articles were selected . The heterogeneity of all data was equilibrium ,and used fixed effects model .The difference showed statistical significance in the his‐tory of hypertension ,Fisher 〉 Ⅱ ,age〉50 years and the posterior circulation aneurysm （P〈0 .05） .and no statistical significance in the sex ,smoking history ,the way of treatment（P〉0 .05） .The symmetry of funnel plots prompted no publication bias .Conclusion Patients with history of hypertension ,Fisher 〉 Ⅱ ,age〈 50 years and the posterior circulation aneurysm are at higher risk of de1ayed cerebral vasospasm ,strengthen close monitoring and management are crucial in these patients .

关 键 词：蛛网膜下腔出血 迟发性脑血管痉挛 危险因素 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]