Ding W, Xiang Y, Liao J, Wang X
Department of Neurosurgery, The First Affiliated Hospital of JiNan University, Guangzhou, Guangdong Province 510632, China.
Neurochirurgie. 2021 Jul;67(4):375-382. doi: 10.1016/j.neuchi.2020.11.004. Epub 2020 Nov 23.
Minimally invasive puncture and conventional craniotomy are both utilized in the treatment of spontaneous supratentorial hemorrhage. The purpose of this study is to review evidence that compares the safety and effectiveness of these two techniques.
We searched EMBASE, Cochrane Library, Web of Science, and PubMed for studies published between 2000 and 2019 that compared the minimally invasive puncture procedure with the conventional craniotomy for the treatment of spontaneous supratentorial hemorrhage.
Seven trials (2 randomized control trials and 5 observational studies) with a total of 970 patients were included. The odds ratio indicated a statistically significant difference between the minimally invasive puncture and conventional craniotomy in terms of good functional outcome (OR 2.36, 90% CI 1.24-4.49). The minimally invasive puncture procedure was associated with lower mortality rates (OR 0.61, 90% CI 0.44-0.85) and rebleeding rates (OR 0.48, 95%CI 0.24-0.99; P=0.003).
The use of the minimally invasive puncture for the management of spontaneous supratentorial hemorrhage was associated with better functional outcome results, a lower mortality rate, and decreased rebleeding rates. However, because insufficient data has been published thus far, we need more robust evidence to provide a better guide for future management.
微创穿刺和传统开颅手术均用于治疗自发性幕上脑出血。本研究的目的是回顾比较这两种技术安全性和有效性的证据。
我们检索了EMBASE、Cochrane图书馆、科学网和PubMed，以查找2000年至2019年期间发表的比较微创穿刺手术与传统开颅手术治疗自发性幕上脑出血的研究。
纳入了7项试验（2项随机对照试验和5项观察性研究），共970例患者。优势比表明，微创穿刺和传统开颅手术在良好功能结局方面存在统计学显著差异（OR 2.36，90%CI 1.24-4.49）。微创穿刺手术的死亡率（OR 0.61，90%CI 0.44-0.85）和再出血率（OR 0.48，95%CI 0.24-0.99；P=0.003）较低。
使用微创穿刺治疗自发性幕上脑出血与更好的功能结局、更低的死亡率和更低的再出血率相关。然而，由于目前发表的数据不足，我们需要更有力的证据为未来的治疗提供更好的指导。
