比较神经内镜与钻孔引流对慢性硬膜下血肿疗效的Meta分析  

Comparison of efficacies between neuroendoscopy and trepanation and drainage on chronic subdural hematoma:a meta-analysis

作　　者：王学建[1] 汪志峰[1] 钱明[1] 姜雷 宋校伟 胡伟梁 Wang Xuejian;Wang Zhifeng;Qian Ming;Jiang Lei;Song Xiaowei;Hu Weiliang(Department of Neurosurgery,Nantong First People's Hospital,Nantong 226001,China)

机构地区：[1]江苏省南通市第一人民医院神经外科,江苏南通226001

出　　处：《中华卫生应急电子杂志》2024年第2期65-69,共5页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：南通市医学重点人才基金项目(重点03);南通市卫健委科技发展计划项目(MA2019003,MA2021017);南京医科大学康达学院科研项目(KD2021JYYJYB025,KD2022KYJJZD022)。

摘　　要：目的比较神经内镜与钻孔引流两种手术方式治疗慢性硬膜下血肿的安全性和有效性。方法运用维普、CNKI、万方三个数据库,检索自1990年3月至2023年2月使用神经内镜技术与单纯钻孔引流治疗慢性硬膜下血肿的RCT研究。对符合纳入标准的文献采用RevMan5.3软件进行Meta分析。结果本研究纳入6项研究,共599例患者。Meta分析提示神经内镜组在住院时间、术后复发及术后并发症较单纯钻孔引流治疗慢性硬膜下血肿存在明显优势,手术时间较对照组长,两种治疗方式存在差异,且差异有统计学意义(P<0.01)。OR合并值(95%CI)分别为14.93(13.35~16.51)、-1.69(-1.85~-1.54)、0.19(0.09~0.37)、0.19(0.10~0.38),差异均有统计学意义(P<0.05)。结论对于慢性硬膜下血肿,采用神经内镜与单纯钻孔引流治疗,两者相比,神经内镜技术除手术时间稍长外,其住院时间短,术后复发及并发症明显少,所以神经内镜技术的安全性及有效性确切,值得推广运用。Objective To compare the safety and efficacy of neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma by meta-analysis.Methods From March 1990 to February 2023,the three databases of Cqvip,CNKI and Wanfang were searched to find out the RCT studies and to compare the neuroendoscopy treatment of chronic subdural hematoma with trephorization alone.Using three databases(Cqvip,CNKI and Wanfang),the RCT studies comparing with neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma from March 1990 to February 2023 were obtained.RevMan5.3 software was used for meta-analysis of the selected literatures that met the inclusion criteria.Results A total of 599 patients were enrolled in 6 studies.Meta-analysis suggested that the neuroendoscopy group had obvious advantages over the control group in terms of length of stay,postoperative recurrence and postoperative complications,and the operation time was longer than that of the control group.There were statistically significant differences between the two treatment modalities(P<0.01).The combined value of OR(95%CI)was 14.93(13.35~16.51),-1.69(-1.85~-1.54),0.19(0.09~0.37),and 0.19(0.10~0.38),respectively and the differences were statistically significant(P<0.05).Conclusion For chronic subdural hematoma,compared with simple burr hole drainage,neuroendoscopy has a slightly longer operation time,a shorter hospital stay,and significantly fewer postoperative recurrence and complications.Therefore,the safety and effectiveness of neuroendoscopy are accurate,worthy of promotion and application.

关 键 词：神经内镜 单纯钻孔引流 慢性硬膜下血肿 META分析 

分 类 号：R65[医药卫生—外科学]