神经内镜下和显微镜下微血管减压术治疗原发性三叉神经痛疗效的meta分析  

Meta-analysis of neuroendoscopic microvascular decompression for idiopathic trigeminal neuralgia

作　　者：逯德胜[1] 陈亮 逯莞婷 展群岭 LU De- sheng;CHEN Liang;LU Wan- ting;ZHAN Qun- ling(Department of Neurosurgery,Shihezi People's Hospital,Shihezi 832000,China;Department of Neurology,Chongqing Renji Hospital,University of Chinese Academy of Science,Chongqing 400060,China;Medical School,Shihezi University,Shihezi 832000,China)

机构地区：[1]石河子市人民医院神经外科,新疆832000 [2]中国科学院大学重庆仁济医院神经内科,重庆400060 [3]石河子大学医学院,新疆石河子832000

出　　处：《中国临床神经外科杂志》2019年第10期602-604,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的系统评价神经内镜下与显微镜下微血管性减压术(MVD)治疗原发性三叉神经痛(INT)的有效性和安全性。方法计算机检索CENTRAL、Medline、EMBASE、中国生物医学文献数据库、中国期刊全文数据库,检索MVD治疗INT的随机对照试验和临床对照试验,检索时限为建库到2018年7月。试验组采用神经内镜下MVD治疗,对照组采用显微镜下MVD治疗。采用RevMan5.3软件进行meta分析。结果共纳入7项研究,包括966例INT,试验组487例,对照组479例。meta分析结果表明:与对照组比较,试验组具有更好的治愈率(OR=1.43,95%CI1.04~1.95,P=0.03)和有效率(OR=3.89,95%CI1.17~12.97,P=0.03);同时,试验组不良事件发生明显降低(OR=0.47,95%CI0.34~0.65,P<0.00001)。结论本文结果表明,与显微镜下MVD比较,神经内镜下MVD治疗INT具有更好的有效性与安全性。Objective To evaluate the outcomes and safety of neuroendoscopic versus microscopic microvascular decompression for idiopathic trigeminal neuralgia(INT).Methods The databases including CENTRAL,Medline,EMBASE,CBMdisc and CNKI were searched for the randomized controlled trials and clinical controlled trials of neuroendscopic versus microscopic microvascular decompression for INT until July,2018.Two researchers independently screened the literature,extracted data and evaluated the quality of the enrolled studies.Then,Meta-analysis of the outcomes and safety of neuroendoscopic versus microscopic microvascular decompression for INT was performed by RevMan 5.3 software.Results A total of 7 trails including 966 patients were acquired.Metaanalysis showed that the cured and effective rates(OR=1.43,95%CI 1.04~1.95,P=0.03;OR=3.89,95%CI 1.17~12.97,P=0.03 respectively)were significantly higher and the occrrent rate of postoperative complications(OR=0.47,95%CI 0.34~0.65,P<0.00001)was significantly lower in the patients with INT treated by euroendoscopic mirovasculer decompression than those in the patients with INT treated by microscopic microvascular decompression.Conclusion The available evidence suggests that the effect of the neuroendoscopic microvascular decompression on INT is good and its safety is better than those of the microscopic microvascular decompression in the patients with INT.

关 键 词：原发性三叉神经痛 微血管减压术 神经内镜 显微镜 有效性 安全性 META分析 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]