运用腰池-腹腔分流术与脑室-腹腔分流术治疗交通性脑积液患者的Meta分析

Application of lumboperitoneal shunt and ventriculoperitoneal shunt in treatment of patients with communicating hydrocephalus:a Meta analysis

目的探讨脑室-腹腔(V-P)和腰池-腹腔(L-P)分流术治疗交通性脑积水患者的疗效。方法采用计算机检索PubMed、Web of Science、Scopuss、Karger、EBSCO+MEDLINE、OVID、EMBASE、中国知网、中国生物医学全文库、万方、维普数据库,查出1990-2016年上述数据库所收录的有关L-P和V-P分流术治疗交通性脑积液的相关文献,并运用STATA12.0软件进行Meta分析。结果交通性脑积液患者予以L-P分流手术的成功率明显高于V-P分流术(P<0.05),术后感染率、分流系统梗阻率及总并发症发生率较低(P<0.05),两组的分流欠佳率差异无统计学意义(P>0.05)。结论 L-P分流术在交通性脑积液患者中值得推荐,由于证据质量较低,需要更多高质量的原始研究来弥补该研究的不足。

Objective To investigate the effect of lumboperitoneal（L-P）shunt and ventriculoperitoneal（V-P）shunt for treating the patients with communicating hydrocephalus.Methods The databases of PubMed,Web of Science,Scopuss,Karge,EBSCO＋MEDLINE,OVID,EMBASE,CNKI,CBM disc databases,Wanfang databases,Weipu databases were retrieved by computer.The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA12.0 software.Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt（P〈0.05）.Moreover,postoperative infection rate,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt（P〈0.05）,However,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt（P〈0.05）.Conclusion L-P shunt is worth recommending.But due to lower quality of the evidences,it is needed more high quality primary studies to remedy the insufficiency of the study.