万古霉素鞘内或脑室内给药治疗颅内感染有效性和安全性的meta分析

Meta-analysis of efficacy and safety of intraventricular or intrathecal injection of vancomycin for intracranial infection

目的:系统评价万古霉素鞘内或脑室内给药治疗颅内感染的安全性和有效性。方法:计算机检索(截至2016年6月)Pubmed、The Corchrane Library、Embase、CNKI、维普、万方等中外数据库中关于万古霉素鞘内或脑室内给药治疗颅内感染的随机对照文献,对符合纳入标准的文献进行质量评价及筛选,采用RevMan5.2软件对最终纳入文献的研究结果进行meta分析。结果:纳入10项随机对照试验,共计622例患者。Meta分析结果显示,鞘内或脑室内给药治疗颅内感染的有效率高于静脉给药组(RR=1.18,95%CI:1.07~1.31,P=0.001),不良反应发生率无显著性差异(RR=0.96,95%CI:0.44~2.11,P=0.92)。结论:万古霉素鞘内或脑室内给药治疗颅内感染的疗效优于单纯静脉滴注,安全性差异无显著性。

Objective: To evaluate the efficacy and safety of intraventricular or intrathecal injection of vancomycin for intracranial infection. Methods: Pubmed, Corchrane Library, Embase, CNKI, VIP and WanFang Databases were electronically searched for randomized controlled trial studies from up to June 2016. According to the inclusion and exclusion criteria, literatures were screened and evaluated. Metaanalysis was performed using RevMan 5.2 software. Results: Finally 10 randomized controlled trials were included involving 622 patients.The effective rate of intrathecal/intraventricular injection was higher than that of the group of intravenous administration for the treatment of intracranial infection(RR=1.18, 95%CI:1.07~1.31,P=0.001),but there was no significant difference in incidence rate of adverse reactions(RR=0.96, 95%CI:0.44~2.11,P=0.92). Conclusion: The administration of intrathecal/intraventricular injection was superior to intravenous administration, and there is no significant difference in safety.