脑出血内、外科治疗随机对照试验的meta分析.pdfVIP

脑出血内、外科治疗随机对照 试验的Meta分析 王宏勤 许世辉 刘晓东 范益民 郝解贺 [摘要] 目的 评价比较内、外科两种方法治疗高血压脑出血的疗效。方法 对所有已发表的 脑出血随机对照试验(RCT)进行Meta分析。结果 (1)共纳入13个符合要求的RCT研究，包括脑 出血患者2842例。(2)Meta分析结果显示脑出血内、外科治疗患者死亡率OR合并值在发病后1个月 为0.73(0.48，1.13)，两组差异无统计学意义(P＞0.05)。但在发病3-12个月后OR合并值为0.77 (0.64，0.91)，外科治疗组明显优于内科治疗组，差异有统计学意义(P＜0.05)。(3)发病3个月以 后，患者生活依赖的OR合并值为0.84(0.39，1.81)，两组差异无统计学意义(P＞0.05)，但在发病 6-12个月后，外科治疗组患者生活能力明显优于保守治疗组，OR值为0.63(0.41，0.98)，差异有统 计学意义。结论 外科手术远期疗效优于内科保守治疗，能显著提高脑出血患者存活率，并有效改 善日常生活能力。 脑出血；手术； Meta分析； 随机对照试验 Metaanalysesofsurgicalandconservativetreatmentofintracerebralhemorrhage WANGHong- qinXUShi-hui LIUXiao-dong FANYi-minHAOJie-he DepartmentofNeurosurgery,TheFirst AffiliatedHospital,ShanxiMedicalUniversity,Taiyuan030001,China [Abstract] Objective Toevaluatetheefficacybetweensurgicaltreatmentandconservative treatmentinintracerebralhemorrhagebymetaanalysis.Method Weidentifiedrandomizedcontrolledtrials (RCT) ofintracerebralhemorrhage.AndMeta-analysiswasconductedonhomogeneousstudies. Result ThirteenRCTs(2842patients)wereincluded.Meta-analysiswasconductedonincludedstudies includingsurgicaltreatmentormedicaltreatmentforintracerebralhemorrhagepatients.ThemortalityOR (95％ CI)valueswas0.73(0.48,1.13)attheendof1month.Therewasnosignificantdifferenceof survivalratebetweentwogroups(surgicaltreatmentgroupandconservativetreatmentgroup,P＞ 0.05).But attheendof3-12months,themortalityOR(95％ CI)valueswas0.77(0.64,0.91).Thedifference betweentwogroupswasnotsignificant(P＜0.05).ThepatientsdependenceOR(95％ CI)valuewas0.84 (0.39,1.81)attheendof3month.Thedifferencebetweentwogroupswasnotsignificant(P＞0.05).But attheendof6-12months,patientsdependenceOR(95％ CI)valuewas0.63(0.41,0.98).The differenceoftwogroupswassignificant(P＜ 0.05).Conclusions Ascomparedwithconservative treatment,surgicaltreatmentcouldremarkablydecreaselong-termmortality,andimprovetheabilityof dailylife. [Ke