Division of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-3410, USA.
Neurosurgery. 2011 Aug;69(2):255-60. doi: 10.1227/NEU.0b013e31821a45ba.
Ventriculostomy placement is an important diagnostic and therapeutic tool for neurosurgeons. Multiple authors have presented retrospective series of patients evaluating periprocedure hemorrhage.
We performed a meta-analysis of existing studies to determine a more accurate rate of hemorrhage.
A MEDLINE and PubMed search was performed to find all studies of 25 or more patients conducted since 1970 that found a hemorrhagic complication rate from placement of a ventriculostomy. Studies in which a non-neurosurgeon placed the ventriculostomy and studies involving premature infants were excluded.
Sixteen studies were used to obtain data from 2428 ventriculostomy procedures. Hemorrhage was found after 203 procedures, and 52 of these hemorrhages were deemed significant by the authors. The cumulative rate of hemorrhage was 7.0% (95% confidence interval: 4.5%-9.4%), with P < .05. The cumulative rate of significant hemorrhage was 0.8% (95% confidence interval: 0.2%-1.4%) with P < .05.
Based on our meta-analysis, the overall hemorrhagic complication rate from ventriculostomy placement by neurosurgeons is approximately 7%. The rate of significant hemorrhage from ventriculostomy placement is approximately 0.8%. Further prospective studies are warranted to better address this question.
脑室造口术是神经外科医生的重要诊断和治疗工具。多位作者已经提出了回顾性系列患者评估围手术期出血的研究。
我们对现有研究进行了荟萃分析，以确定更准确的出血率。
进行了 MEDLINE 和 PubMed 检索，以查找自 1970 年以来发表的所有 25 例或以上患者的研究，这些研究发现脑室造口术出血并发症的发生率。排除了非神经外科医生进行脑室造口术的研究和涉及早产儿的研究。
16 项研究用于从 2428 例脑室造口术获得数据。203 例出现出血，其中 52 例被作者认为是显著的。出血的累积发生率为 7.0%（95%置信区间：4.5%-9.4%），P<.05。显著出血的累积发生率为 0.8%（95%置信区间：0.2%-1.4%），P<.05。
根据我们的荟萃分析，神经外科医生进行脑室造口术的总体出血并发症发生率约为 7%。脑室造口术引起的严重出血发生率约为 0.8%。需要进一步的前瞻性研究来更好地解决这个问题。
