微创手术和保守治疗高血压性脑出血疗效的Meta分析

Meta analyses of curative effects on hypertensive cerebral hemorrhage: minimally invasive surgery versus conservative treatment

目的系统评价微创手术和保守治疗高血压性脑出血的疗效。方法计算机检索PubMed、EMBASE、CochraneCentral Register of Controlled Trials、中国期刊网全文数据库、中国生物医学文献数据库、维普数据库及万方数据库中关于微创手术和保守治疗高血压性脑出血的随机对照研究,并进行Meta分析。结果共纳入21项(4 241例)符合标准的随机对照研究,Meta分析显示,微创手术的有效率明显优于保守治疗(OR=2.85;95%CI 2.45~3.31;P<0.00001)。微创手术的发病后6个月GOS评分率明显优于保守治疗(OR=4.95;95%CI 3.69~6.64;P<0.00001)。结论与保守治疗相比,微创手术治疗高血压性脑出血既有效又安全,明显提高治疗有效率,明显改善病人的生存质量。

Objective To investigate the clinical effect of minimally invasive surgery on the hypertensive cerebral hemorrhage （HCH）. Methods The articles of the randomized controlled studies of minimally invasive surgical treatment of HCH were searched from databases including PUBMED, EMBASE, Cochrane Central Register of Controlled Trials, The Chinese Journal Full-text Database, China Biomedical Literature Database, VIP Database and Wanfang Database by computer. Meta analysis of the curative effects of minimally invasive surgery and conservative treatment on HCH was performed. Results A total of 21 （4 241 cases） randomly controlled studies about the treatment of HCH by minimally invasive surgery and conservative treatment were searched out. The total effective rate was statistically higher in the minimally invasive surgery group than that in the conservative treatment group （OR=2.85; 95%CI 2.45~3.31; P〈0.00001）. And the life ability was significantly better in the minimally invasive surgery group than that in the conservative treatment group. Conclusions The minimally invasive surgery is an effective and safe method to treat HCH and can greatly improve the prognoses in the patients with HCH compared to the conservative treatment.