去骨瓣减压术治疗恶性大脑中动脉脑梗死疗效的Meta分析

被引：7

作者：

余勇飞 ^{[1
]}

魏衡 ^{[1
]}

周瑞 ^{[1
]}

刘晓利 ^{[1
]}

郭珍立 ^{[1
]}

许康 ^{[1
]}

杜继臣 ^{[2
]}

机构：

[1] 湖北省新华医院神经内科

[2] 北京大学航天临床医学院神经内科

来源：

中华临床医师杂志(电子版) | 2013年 / 7卷 / 04期

关键词：

脑梗死; 随机对照试验; Meta分析; 去骨瓣减压术;

D O I：

暂无

中图分类号：

R651.1 [颅脑];

学科分类号：

摘要：

目的系统评价去骨瓣减压术治疗恶性大脑中动脉脑梗死的疗效及安全性。方法计算机检索PubMed、EMbase、Springer、Cochrane Library、CNKI和万方数据库,查找去骨瓣减压术治疗恶性大脑中动脉脑梗死的随机对照试验(RCT),检索时间截至2012年6月。按Cochrane系统评价方法对纳入研究进行资料提取和质量评价,并采用Stata软件进行Meta分析。结果共纳入4个RCT,共181例恶性大脑中动脉脑梗死患者(93例为去骨瓣减压术,88例为内科治疗),其中发病48h内行去骨瓣减压术的患者82例和内科治疗患者74例。Meta分析结果表明:发病48h内行去骨瓣减压术治疗1年后随访mRS>3分(OR=0.42,95%CI0.20～0.89)、mRS>4分(OR=0.12,95%CI0.06～0.25)及死亡人数(OR=0.10,95%CI0.05～0.21)均少于内科治疗患者,差异均有统计学意义(均P<0.05)。结论去骨瓣减压术能够降低恶性大脑中动脉脑梗死患者治疗1年后随访的重度残疾和死亡人数,手术时间在发病48h以内效果好,但具体最佳时间窗仍不确切。去骨瓣减压术是治疗急性大面积脑梗死的一种较好方式。

引用

页码：1669 / 1673

页数：5

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