尼莫地平联合神经节苷脂治疗脑出血疗效的Meta分析

Meta-analysis of the efficacy of nimodipine combined with ganglioside in the treatment of intracerebral hemorrhage

目的通过Meta分析评价尼莫地平联合神经节苷脂治疗脑出血的效果及安全性。方法检索国内外数据库中有关尼莫地平联合神经节苷脂治疗脑出血的随机对照试验(RCT),检索范围从数据库建立至2019年5月1日。文献筛选、偏倚风险评估、数据提取均由两人独立完成,最后采用RevMan 5.3软件进行Meta分析。结果Meta分析结果显示:尼莫地平联合神经节苷脂治疗脑出血临床总有效率明显高于对照组[OR=5.61,95%CI(3.19,9.86),P<0.05];治疗后联合治疗组水肿面积显著小于对照组[SMD=-2.05,95%CI(-2.34,-1.76),P<0.05];治疗后联合治疗组血肿体积小于对照组[SMD=-1.01,95%CI(-1.26,-0.76),P<0.05];治疗后联合治疗组NIHSS评分明显低于对照组[MD=-5.59,95%CI(-6.63,-4.55),P<0.05]。结论在常规治疗的基础上,尼莫地平联合神经节苷脂比单独用药治疗脑出血效果显著,能够改善患者预后,减小颅内水肿面积和脑内血肿体积。

Objective To evaluate the efficacy and safety of nimodipine combined with ganglioside in the treatment of intracerebral hemorrhage by meta-analysis.Methods The randomized controlled trial(RCT)of nimodipine combined with ganglioside in the treatment of intracerebral hemorrhage in domestic and foreign databases were searched.The retrieval scope was from the establishment of the database to May 1,2019,literature screening,data extraction,risk assessment were completed by two researchers independently,and the meta-analysis was conducted by RevMan5.3 software.Results The results of meta-analysis showed that the efficacy of nimodipine combined with ganglioside in treating intracerebral hemorrhage was significantly higher than that in the control group[OR=5.61,95%CI(3.19,9.86),P<0.05].Edema area in the combined treatment group after treatment was significantly smaller than that in the control group[SMD=-2.05,95%CI(-2.34,-1.76),P<0.05].The hematoma volume in the combined treatment group after treatment was smaller than that in the control group[SMD=-1.01,95%CI(-1.26,-0.76),P<0.05].NIHSS score in the combined treatment group after treatment was significantly lower than that in the control group[MD=-5.59,95%CI(-6.63,-4.55),P<0.05].Conclusion On the basis of conventional treatment,nimodipine combined with ganglioside is more effective than single treatment for intracerebral hemorrhage,which can improve the prognosis of patients and reduce the area of intracranial edema and volume of intracerebral hematoma.