第三脑室底造瘘术与脑室-腹腔分流术治疗儿童脑积水效果的Meta分析(1)
[摘要] 目的 探討第三脑室底造瘘术(ETV)与脑室-腹腔分流术(VPS)两种术式治疗儿童脑积水的临床效果。 方法 通过计算机检索中国知网、万方数据知识服务平台、维普数据库、PubMed、Embase、Cochrane library数据库，按照纳入和排除标准获取从建库到2018年10月收录的相关文献，采用Newcastle-Ottawa量表及Jadad量表进行文献的质量评价，使用Stata 15.0软件进行Meta分析。 结果 ETV与VPS治疗儿童脑积水手术有效率(OR = 1.50，95%CI：0.82～2.74，P = 0.189)、术后总并发症的发生率(OR = 0.73，95%CI：0.36～1.51，P = 0.394)、术后颅内血肿发生率(OR = 1.16，95%CI：0.51～2.66，P = 0.726)比较，差异无统计学意义，术后颅内感染发生率(OR = 0.27，95%CI：0.12～0.57，P = 0.001)、术后分流阻塞发生率(OR = 0.17，95%CI：0.06～0.43，P = 0.000)及术后再次手术率(OR = 0.20，95%CI：0.07～0.56，P = 0.002)比较，差异有统计学意义。 结论 ETV在术后并发症及是否再次手术方面优于VPS，更多优势仍需进一步临床研究观察。
[关键词] 儿童脑积水;第三脑室底造瘘术;脑室-腹腔分流术;Meta分析
[中图分类号] R726.5 [文献标识码] A [文章编号] 1673-7210(2019)07(a)-0102-07
Meta analysis of endoscopic third ventriculostomy and ventriculoperitoneal shunt for treating hydrocephalus in chirdren
FENG Xin1 HUANG Xintao2 HE Yong1 GUO Xiaolong2 ZHAO Xueming2
1.The First Clinical Medical College of Shanxi Medical University， Shanxi Province， Taiyuan 030000， China; 2.Department of Neurosurgery， the First Hospital of Shanxi Medical University， Shanxi Province， Taiyuan 030000， China
[Abstract] Objective To investigate the clinical effects of the third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of hydrocephalus in children. Methods Relevant literatures collected from the establishment of the database to October 2018 were obtained according to inclusion and exclusion criteria through computer retrieval of China national knowledge network， Wanfang data knowledge service platform， VIP database， PubMed， Embase and Cochrane library databases. The Newcastle-Ottawa scale and Jadad scale were used for literature quality evaluation， and Stata 15.0 software was used for Meta analysis. Results There was no statistically significant difference in the effective rate (OR = 1.50， 95%CI： 0.82-2.74， P = 0.189)， the incidence of total postoperative complications (OR = 0.73， 95%CI： 0.36-1.51， P = 0.394)， the incidence of intracranial hematoma after operation (OR = 1.16， 95%CI： 0.51-2.66， P = 0.726) of ETV and VPS in the treatment of hydrocephalus in children. The incidence of postoperative intracranial infection (OR = 0.26， 95%CI： 0.12-0.57， P = 0.001)， the incidence of postoperative shunt obstruction (OR = 0.17， 95%CI： 0.06-0.43， P = 0.000)， the rate of reoperation after operation (OR = 0.20， 95%CI： 0.07-0.56， P = 0.002) were statistically significant. Conclusion ETV is superior to VPS in postoperative complications and whether or not to have another operation. More advantages still need to be further observed in clinical studies., 百拇医药(冯昕 黄忻涛 何勇 郭晓隆 赵学明)
[关键词] 儿童脑积水;第三脑室底造瘘术;脑室-腹腔分流术;Meta分析
[中图分类号] R726.5 [文献标识码] A [文章编号] 1673-7210(2019)07(a)-0102-07
Meta analysis of endoscopic third ventriculostomy and ventriculoperitoneal shunt for treating hydrocephalus in chirdren
FENG Xin1 HUANG Xintao2 HE Yong1 GUO Xiaolong2 ZHAO Xueming2
1.The First Clinical Medical College of Shanxi Medical University， Shanxi Province， Taiyuan 030000， China; 2.Department of Neurosurgery， the First Hospital of Shanxi Medical University， Shanxi Province， Taiyuan 030000， China
[Abstract] Objective To investigate the clinical effects of the third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in the treatment of hydrocephalus in children. Methods Relevant literatures collected from the establishment of the database to October 2018 were obtained according to inclusion and exclusion criteria through computer retrieval of China national knowledge network， Wanfang data knowledge service platform， VIP database， PubMed， Embase and Cochrane library databases. The Newcastle-Ottawa scale and Jadad scale were used for literature quality evaluation， and Stata 15.0 software was used for Meta analysis. Results There was no statistically significant difference in the effective rate (OR = 1.50， 95%CI： 0.82-2.74， P = 0.189)， the incidence of total postoperative complications (OR = 0.73， 95%CI： 0.36-1.51， P = 0.394)， the incidence of intracranial hematoma after operation (OR = 1.16， 95%CI： 0.51-2.66， P = 0.726) of ETV and VPS in the treatment of hydrocephalus in children. The incidence of postoperative intracranial infection (OR = 0.26， 95%CI： 0.12-0.57， P = 0.001)， the incidence of postoperative shunt obstruction (OR = 0.17， 95%CI： 0.06-0.43， P = 0.000)， the rate of reoperation after operation (OR = 0.20， 95%CI： 0.07-0.56， P = 0.002) were statistically significant. Conclusion ETV is superior to VPS in postoperative complications and whether or not to have another operation. More advantages still need to be further observed in clinical studies., 百拇医药(冯昕 黄忻涛 何勇 郭晓隆 赵学明)