显微手术夹闭和血管内栓塞治疗颅内动脉瘤有效性的Meta分析  

Meta Analysis of the Efficacy of Microsurgery Clipping and Endovascular Embolization Treatment of Intraeranial Aneurysm

作　　者：胡欣[1] 萧乾[1] 彭秋平[1] 杨建平[1] 戚燕[2] HU Xin XIAO Qian PENG Qiu-ping(Neurosurgery, Ji＇an Central People＇s Hospital, Ji＇an, Jiangxi, 343000, Chin)

机构地区：[1]吉安市中心人民医院神经外科,江西吉安343000 [2]井冈山大学医学部,江西吉安343009

出　　处：《黑龙江医学》2016年第12期1116-1118,共3页Heilongjiang Medical Journal

摘　　要：目的系统评价显微手术夹闭和血管内栓塞治疗颅内动脉瘤有效性,以期为颅内动脉瘤的治疗提供依据。方法计算机检索CNKI、VIP、Wan Fang Data、Pub-Med、The Cochran Library和Web of Science,搜集有关颅内动脉瘤治疗方法的随机对照研究,检索时限截至2016年3月。采用Rev Man 5.3软件进行Meta分析。结果共纳入12篇文献。Meta分析结果显示:血管内栓塞组术后GOS评分5分以上数量高于显微手术夹闭组,血管内栓塞组平均住院时间明显短于显微手术夹闭组,差异均有统计学意义(P<0.01);显微手术夹闭和血管内栓塞术后脑血管痉挛发生率和脑积水的发生率相当,差异均无统计学意义(P>0.05)。结论血管内栓塞治疗颅内动脉瘤术后GOS评分明显高于显微手术夹闭,而且住院天数较少,但费用较高。两种手术方法治疗颅内动脉瘤脑血管痉挛发生率和脑积水发生率相当。因此,在临床上要根据患者的实际情况制定最佳治疗方案。Objective To evaluate the effectiveness of microsurgery clipping and endovascular embolization treatment of intraeranial aneurysm. Methods Databases,including CNKI,VIP,Wan Fang Data,Pub-Med,The Cochran Library and Web of Science,were electronically searched to collect randomized controlled trials（ RCTs） involving the treatment of intraeranial aneurysm. The retrieval time was from March,2016. Then data was analyzed by Rev Man 5. 3 software. Results A total of 12 studies were included in the meta-analysis.The results of meta-analysis showed that the effective rate of endovascular embolization was significantly higher than that of microsurgical clipping. The average length of stay in the endovascular embolization group was significantly shorter than that in the microsurgical clipping group. The difference was statistically significant（ P〈0. 01）. There was no significant difference in the incidence of cerebral vasospasm and hydrocephalus after microsurgical clipping and endovascular embolization（ P〉0. 05）. Conclusion Score of endovascular embolization treatment in the postoperative GOS is significantly higher than the microsurgical clipping,and hospital days are less,but the cost is higher.Cerebral vasospasm and hydrocephalus occur in two types of surgical procedures. Therefore doctors should make the best treatment plan according to the actual situation of the patient in clinic.

关 键 词：颅内动脉瘤 显微手术 血管内栓塞 系统评价 

分 类 号：R651[医药卫生—外科学]