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颅外-颅内动脉搭桥术治疗烟雾病的安全性

Safety of Extracranial-Intracranial Arterial Bypass in the Treatment of Moyamoya Disease.

作者信息

Liu Lian, Su Song Wei, Sun Hong Yan

机构信息

*Nursing School, Southwest Medical University, Luzhou†Basic Medical College, Guangzhou University of Chinese Medicine, Guangzhou University Island, Guangzhou, China.

出版信息

J Craniofac Surg. 2017 Sep;28(6):e522-e527. doi: 10.1097/SCS.0000000000003390.

Abstract

OBJECTIVE

The purpose of this study is to uncover the controversial problems and review the safety of extracranial-intracranial arterial bypass (EC-IC arterial bypass) in the treatment of moyamoya disease.

METHODS

Published randomized controlled clinical trials were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of science without date or language limitations until September 2016. Meta-analysis was performed as recommended by the Cochrane Collaboration of trials.

RESULTS

In total 2 studies were included by strict inclusion and exclusion criteria. The result of meta-analysis showed that surgical group had a greater reduction of the primary end points (OR [0.35], 95% CI [0.15, 0.84], I = 0%) than that of the nonsurgical group.

CONCLUSION

Surgical therapy significantly lowers incidence of the primary end points (including rebleeding attack; completed stroke resulting in significant morbidity; mortality from any medical cause and requirement for bypass surgery fora nonsurgical patient as determined by a registered neurologist) compared with nonsurgical therapy. High-quality randomized controlled trials are required to confirm this conclusion.

摘要

目的

本研究旨在揭示有争议的问题,并回顾颅外-颅内动脉搭桥术(EC-IC动脉搭桥术)治疗烟雾病的安全性。

方法

从PubMed、EMBASE、Cochrane对照试验中央登记库和科学网检索截至2016年9月发表的随机对照临床试验,无日期或语言限制。按照Cochrane协作网对试验的推荐进行荟萃分析。

结果

通过严格的纳入和排除标准,共纳入2项研究。荟萃分析结果显示,手术组的主要终点降低幅度大于非手术组(比值比[0.35],95%置信区间[0.15, 0.84],I = 0%)。

结论

与非手术治疗相比,手术治疗显著降低了主要终点的发生率(包括再出血发作;导致严重致残的完全性卒中;任何医疗原因导致的死亡以及由注册神经科医生确定的非手术患者进行搭桥手术的需求)。需要高质量的随机对照试验来证实这一结论。

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