手术联合阿托伐他汀治疗慢性硬膜下血肿效果的meta分析  

Meta-analysis of operation combined with Atorvastatin treatment for chronic subdural hematoma

作　　者：甘燕玲 邓煜二 张志强[2] 李聪[2] 詹文刚 谭齐家[2] 谢才军[2] GAN Yanling;DENG Yu′er;ZHANG Zhiqiang;LI Cong;ZHAN Wengang;Tan Qijia;XIE Caijun(the Second School of Clinical Medicine,Guangzhou University of Chinese Medicine,Guangdong Province,Guangzhou510006,China;the Second Department of Neurology,University Town Hospital of Guangdong Hospital of Traditional Chinese Medicine,Guangdong Province,Guangzhou510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510006 [2]广东省中医院大学城医院神经二科,广东广州510120

出　　处：《中国医药导报》2020年第20期70-75,92,共7页China Medical Herald

基　　金：广东省科技计划项目(2014A020212411)。

摘　　要：目的系统评价手术联合阿托伐他汀治疗慢性硬膜下血肿的临床效果。方法计算机检索万方、CNKI、CBM、PubMed、Embase、Web of Science数据库,检索期限为各数据库建库至2019年5月,纳入手术联合阿托伐他汀治疗慢性硬膜下血肿的随机对照试验。使用RevMan 5.3软件对有效率、并发症发生率、复发率等结局指标进行meta分析。结果最终纳入16篇文献。meta分析结果显示,治疗组有效率高于对照组(OR=5.74,95%CI:3.83,8.62,P<0.05),治疗组CSS评分低于对照组(MD=-4.37,95%CI:-5.17,-3.57,P<0.05),治疗组感染发生率低于对照组(OR=0.22,95%CI:0.10,0.46,P<0.05),治疗组颅内气肿发生率低于对照组(OR=0.19,95%CI:0.08,0.45,P<0.05),治疗组脑损伤发生率低于对照组(OR=0.12,95%CI:0.04,0.36,P<0.05),治疗组复发率低于对照组(OR=0.06,95%CI:0.03,0.15,P<0.05)。两组血肿量增加发生率、肝肾功能异常发生率比较,差异无统计学意义(P>0.05)。结论手术联合阿托伐他汀治疗慢性硬膜下血肿临床效果确切,且复发率和并发症发生率相对较低,但尚需高质量、大样本的多中心随机临床试验加以验证。Objective To systematically evaluate the clinical effect of operation combined with Atorvastatin in the treatment of chronic subdural hematoma.Methods Wanfang,CNKI,CBM,PubMed,Embase and Web of Science databases were searched by computer and the retrieval period was from biuilding database to May 2019.Randomized controlled trials of operation combined with Atorvastatin in the treatment of chronic subdural hematoma were included.Meta-analysis was conducted on outcome indicators such as efficiency,incidence of complications and recurrence rate with RevMan 5.3 software.Results Finally,16 literatures were included.The results of meta analysis showed that the effective rate of treatment group was higher than that of control group(OR=5.74.95%CI:3.83,8.62,P<0.05),CSS scores in treatment group was lower than that in control group(MD=-4.37,95%CI:-5.17,-3.57,P<0.05),the incidence of infection in treatment group was lower than that of control group(OR=0.22,95%CI:0.10,0.46,P<0.05),the incidence of intracranial emphysema in treatment group was lower than that in control group(OR=0.19,95%CI:0.08,0.45,P<0.05),the incidence of brain injury in treatment group was lower than that in control group(OR=0.12,95%CI:0.04,0.36,P<0.05)and the recurrence rate in treatment group was lower than that in control group(OR=0.06,95%CI:0.03,0.15,P<0.05).There was no significant difference in the incidence of the increase of hematoma and the incidence of hepatic and renal dysfunction between treatment group and control group(P>0.05).Conclusion Operation combined with Atorvastatin in the treatment of chronic subdural hematoma has a definite clinical effect.However,it needs to be verified by multi-center randomized clinical trials with high quality and large samples in the future.

关 键 词：慢性硬膜下血肿 阿托伐他汀 手术 META分析 

分 类 号：R651.1[医药卫生—外科学]