阿托伐他汀联合地塞米松口服对慢性硬膜下血肿钻孔引流术后血肿复发影响的meta分析

Meta-analysis of the effect of atorvastatin combined with dexamethasone on the recurrence of chronic subdural hematoma after drilling and drainage

目的研究阿托伐他汀(ATO)联合地塞米松(DXM)对慢性硬膜下血肿(CSDH)钻孔引流术后血肿复发的影响。方法应用系统评价方法,检索PubMed、Cochrane、Embase、中国知网、万方数据库中关于阿托伐他汀联合地塞米松口服辅助钻孔引流术治疗CSDH的相关文献,建库至2021年12月31日。将所有符合标准的文献纳入这次研究中,提取分析的指标为血肿复发率,采用纽斯卡尔-渥太华文献质量评分量表(NOS)对纳入的文献进行了质量评价。利用Revman5.3统计软件进行Meta分析。结果本次研究一共纳入了5篇临床文献,包括338名患者,所有纳入文献NOS评分为6~8分。ATO联合DXM组的血肿复发率(1.2%)明显低于对照组(单一口服ATO)(13.6%),差异具有统计学意义(OR=0.12,95%CI为0.04~0.39,P<0.001,I2=0%)。结论CSDH患者在钻孔引流术后联合口服ATO和DXM相较单一口服ATO可使血肿复发率降低,对于反复复发或有复发高危风险的CSDH患者,可在钻孔引流管术后联合口服ATO及DXM。

Objective To study the effect of atorvastatin(ATO)combined with dexamethasone(DXM)on the recurrence of chronic subdural hematoma after drilling and drainage.Methods By using the method of systematic evaluation,the relevant literatures on Atorvastatin Combined with dexamethasone in the treatment of chronic subdural hematoma in PubMed,Cochrane,EMBASE,CNKI,Wanfang and other databases were retrieved,and the database was established until December 31,2021.The eligible literatures were included in the study.The extracted analysis index was the recurrence rate of hematoma.The quality of the included literatures was evaluated by the Newcastle Ottawa document quality rating scale(NOS).The revman5.3 statistical software was used for meta-analysis.Results A total of 5 articles were included in this study,including 338 patients.The NOS score of the included articles was 6~8.The recurrence rate of hematoma in ATO combined with DXM group(1.2%)was significantly lower than that in control group(single oral ATO)(13.6%),and the difference was statistically significant(OR=0.12,95%CI:0.04~0.39,P<0.001,I~2=0%).Conclusion Compared with single oral ATO,oral ATO and DXM can reduce the recurrence rate of hematoma in CSDH patients after drilling and drainage.For CSDH patients with repeated recurrence or high risk of recurrence,oral ATO and DXM can be taken after drilling and drainage.