神经内镜手术和显微手术治疗幕上高血压性脑出血疗效的Meta分析

Comparison of endoscopic surgery and craniotomy for supratentorial hypertensive intracerebral hemorrhage:a meta-analysis

目的比较神经内镜手术与显微手术治疗幕上高血压性脑出血的疗效及安全性。方法计算机检索Pub Med、Medline、EMbase、Cochrane等英文数据库及CNKI、万方、维普等中文数据库,搜集1997年1月至2017年6月关于对比神经内镜手术与显微手术治疗幕上高血压性脑出血的研究,使用Rev Man 5.1软件进行Meta分析。结果共纳入3篇随机对照研究和10篇病例对照研究,1 163例中神经内镜组570例,显微手术组593例。Meta分析结果显示,神经内镜手术治疗幕上高血压性脑出血血肿清除率高,手术时间及住院时间短,术中失血少,病死率及并发症发生率低(P<0.05)。结论神经内镜手术治疗幕上高血压性脑出血的安全性及有效性均高于显微手术。

Objective To evaluate the curative effects of endoscopic surgery and craniotomy on supratentorial hypertensive intracerebral hemorrhage(SHIH)and their safety.Methods The databases including PubMed,Medline,EMbase,Cochrane,CNKI,Wanfang and VIP were searched for original articles about endoscopic surgery for SHIH in comparison with craniotomy from January,1997 to June,2017.A Meta analysis of these data was performed by RevMan5.1 software.Results Three articles about randomized controlled trial and ten articles about case-controls studies of endoscopic surgery versus craniotomy for SHIH including 1 163 patients were involved in the study.Of 1 163 patients with SHIH,570 received endoscopic surgery and 593 craniotomy.Meta-Analysis revealed that the hematoma evacuation rate was significantly higher,the operative time and hospital stay were significantly shorter,the intraoperative blood loss volume was significantly less,the mortality rate and the postoperative complication rate were significantly lower in the patients with SHIH undergoing the endoscopic surgery than those in the patients with SHIH undergoing the craniotomy(P<0.05).Conclusion The curative effects of the endoscopic surgery on SHIH and its safety are significantly better than those of the craniotomy.