荧光素钠注射液引导手术切除脑胶质瘤临床疗效的系统评价

Systematic Review on Clinical Efficacy of Fluorescein Sodium Injection-Guided Surgical Resection of Glioma

目的:系统评价荧光素钠注射液引导手术切除脑胶质瘤的临床疗效。方法:通过检索PubMed、Embase、中国知网、维普数据库、中国生物医学文献数据库及万方数据库,收集荧光素钠注射液引导手术切除脑胶质瘤的随机对照试验(RCT),检索时限均为建库至2021年4月,对符合质量标准的RCT进行Meta分析,采用RevMan 5.2软件进行统计学分析。结果:共纳入6篇RCT研究,涉及333例患者;观察组患者在常规脑胶质瘤显微手术切除过程中,通过静脉注射荧光素钠注射液将肿瘤组织染色,根据其荧光染色强弱判断肿瘤的边界进行肿瘤切除;对照组患者采用常规显微手术切除脑胶质瘤。Meta分析结果显示,观察组患者肿瘤全切除率明显高于对照组(OR=5.51,95%CI=3.28~9.24,P<0.00001),术后脑胶质瘤复发率明显低于对照组(OR=0.30,95%CI=0.15~0.60,P=0.0006),差异均有统计学意义;两组患者平均手术持续时间、平均住院时间的差异均无统计学意义(P>0.05)。结论:与常规显微手术相比,采用荧光素钠注射液引导手术切除脑胶质瘤的肿瘤全切除率更高,术后肿瘤复发率更低。

OBJECTIVE:To systematically evaluate the clinical efficacy of using fluorescein sodium injection to guide surgical resection of glioma.METHODS:PubMed,Embase,CNKI,VIP,CBM and Wanfang Data were retrieved to collect the randomized controlled trials(RCT)of efficacy of fluorescein sodium injection-guided surgical resection of glioma.The retrieval time was from the establishment of the database to Apr.2021.Meta-analysis was performed on RCT that met the quality standards,and RevMan 5.2 was used for statistical analysis.RESULTS:A total of 6 RCT with 333 patients were included.During the routine microsurgical resection of glioma in the observation group,the tumor tissue was stained by intravenous injection of sodium fluorescein injection,and the tumor boundary was judged according to the intensity of the fluorescent staining to perform tumor resection;the control group was resected by conventional microsurgery glioma.Meta-analysis showed that the total resection rate of glioma in the observation group was significantly higher than that in the control group(OR=5.51,95%CI=3.28-9.24,P<0.00001),the recurrence rate of glioma in the observation group after surgery was significantly lower than that in the control group(OR=0.30,95%CI=0.15-0.60,P=0.0006),with statistically significant differences.There were no significant differences in the average duration of surgery and average length of stay between two groups(P>0.05).CONCLUSIONS:Compared with conventional microsurgery,fluorescein sodium injection-guided surgical resection of glioma has a higher total tumor resection rate and a lower postoperative tumor recurrence rate.