Department of Neurosurgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
Ann Palliat Med. 2021 Oct;10(10):11129-11140. doi: 10.21037/apm-21-2728.
Lumbar continuous drainage of fluid (LCDF) has become more widely used in the diagnosis and treatment of neurological diseases in recent years. The use of LCDF can enable a better understanding of the patient's condition and reduce the incidence of related complications. LCDF can also affect complications of perforation surgery, including mortality during hospitalization, cerebral vasospasm (CVS), bleeding, and aneurysmal subarachnoid hemorrhage (aSAH).
Articles published from library construction to April 2021 were searched for in the English-language databases PubMed, Cochrane Library, and Embase. All randomized controlled trials (RCTs) with LCDF and hole locking surgery were meta-analyzed using the Cochrane Collaboration's RevMan 5.3 software.
Ten RCTs involving 1,092 patients (continuous drainage group, n=585; control group, n=507) were included in the meta-analysis. For the statistical different in incidence of perioperative cerebral infarction in the two groups, the odds ratio (OR) was 5.42 [95% confidence interval (CI): (2.71, 10.83); P<0.00001], and for the statistical difference in the incidence of cerebral hemorrhage, the OR was 4.76 [95% CI: (2.11, 10.76); P=0.0002]. Perioperative complications were fewer in the LCDF-treated drainage group than in the conventional group.
This meta-analysis of 10 RCTs confirmed that LCDF compared with other treatments is associated with a lower incidence of perioperative complications, such as cerebral hemorrhage, hydrocephalus, and cerebral infarction, as well as increased Glasgow Outcome Scale (GOS).
近年来，腰椎持续引流（LCDF）在神经科疾病的诊断和治疗中得到了更广泛的应用。使用 LCDF 可以更好地了解患者的病情，并降低相关并发症的发生率。LCDF 还会影响穿孔手术的并发症，包括住院期间的死亡率、脑血管痉挛（CVS）、出血和脑动脉瘤性蛛网膜下腔出血（aSAH）。
在 PubMed、Cochrane Library 和 Embase 英文数据库中检索了从图书馆建设到 2021 年 4 月发表的文章。使用 Cochrane 协作的 RevMan 5.3 软件对所有使用 LCDF 和孔锁手术的随机对照试验（RCT）进行荟萃分析。
纳入了 10 项 RCT，共 1092 例患者（持续引流组，n=585；对照组，n=507）进行荟萃分析。对于两组围手术期脑梗死发生率的统计学差异，比值比（OR）为 5.42 [95%置信区间（CI）：（2.71，10.83）；P<0.00001]，对于脑出血发生率的统计学差异，OR 为 4.76 [95% CI：（2.11，10.76）；P=0.0002]。LCDF 治疗引流组的围手术期并发症少于常规组。
这项对 10 项 RCT 的荟萃分析证实，与其他治疗方法相比，LCDF 与较低的围手术期并发症发生率相关，如脑出血、脑积水和脑梗死，以及格拉斯哥预后评分（GOS）的提高。
