支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析  

A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety

作　　者：周有东 敖祥生[1] 刘汉东[1] 王志勇[1] 朱耀祖[1] 周达全[1] 

机构地区：[1]襄阳市中心医院神经外科,湖北441021

出　　处：《中国临床神经外科杂志》2016年第5期274-277,280,共5页Chinese Journal of Clinical Neurosurgery

摘　　要：目的系统比较支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤的疗效及安全性。方法计算机检索Pubmed、中国知网和万方等数据库,检索所有比较支架辅助弹簧圈与单纯弹簧圈栓塞治疗颅内动脉瘤的临床对照研究,检索时间截止至2015年6月1日。采用Rev Man 5.2和Stata 11进行Meta分析入选文献并发症发生率、进展性血栓发生率、复发率、血栓栓塞率、永久性并发症率及死亡率。结果最终纳入11个研究,共3 078例,其中支架辅助弹簧圈治疗1 022例,单纯弹簧圈治疗2 056例。与单纯性弹簧圈治疗相比,支架辅助弹簧圈治疗发生进展性血栓比率明显升高(P<0.05),但复发率明显降低(P<0.05);而两组总体并发症发生率、永久性并发症率、血栓栓塞率及死亡率无明显差异(P>0.05)。结论支架辅助弹簧圈栓塞治疗颅内动脉瘤相较于单纯弹簧圈具有更低的复发率及较高的进展性血栓发生率;而在其他并发症事件方面,两种手术方式无明显差异。Objective To compare the curative effects of stent-assisted coiling on intracranial aneurysms and its safety with simple coiling. Methods All the control studies related to comparison ofthe curative effects of stent-assisted coiling on the intracranial aneurysm and its safety with simple coiling were searched from Pubmed, Cochrane Library, EMbase, CNKI and Wanfang databases up to June 1, 2015. The Mata-analysis of the occurrent rates of progressive thrombosis, all the complications, permanent complication, and thromboembolic complication, recurrent rate of aneurysms and mortality were performed by RevMan 5.2 and Statall. Results Eleven studies including 3 078 patients related to comparison of the curative effect of stent-assisted coiling on the intracranial aneurysms and its safety with simple coiling were found out. The occurrent rate of the progressive thromboembolia was significantly higher and recurrent rate of the intracranial aneurysms was significantly lower in the stent-assisted coiling group than those in the simple coiling group （P〈 0.01）. There were insignificant differences in the rates of the all the complications, permanent complication and thromboembolic complication and mortality between both the groups. Conclusion It is suggested that stent-assisted coiling may decrease the recurrence rate of the intracranial aneurysms and enhance the occurrent rate of the progressive thromboembolia compare to the simple coiling.

关 键 词：颅内动脉瘤 血管内栓塞 支架 弹簧圈 疗效 安全性 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]