中低收入国家脊髓脊膜膨出相关脑积水的管理和结局：系统评价和荟萃分析方案。

Management and outcomes of myelomeningocele-associated hydrocephalus in low-income and middle-income countries: a systematic review and meta-analysis protocol.

机构信息

Faculty of Health Sciences, University of Buea, Buea, Cameroon.

Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.

出版信息

BMJ Open. 2023 Feb 7;13(2):e066339. doi: 10.1136/bmjopen-2022-066339.

DOI:10.1136/bmjopen-2022-066339

PMID:36750288

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9906258/

Abstract

INTRODUCTION

Hydrocephalus and myelomeningocele (MMC) place disproportionate burdens of disease on low-income and middle-income countries (LMICs). MMC-associated hydrocephalus and its sequelae result in a spectrum of severely devastating clinical manifestations, for which LMICs are disproportionately unprepared in terms of human, capital and technological resources. This study aims to review and compare the management and outcomes of infant MMC-associated hydrocephalus in LMICs and high-income countries.

METHODS AND ANALYSIS

This systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The following databases will be searched without restrictions on language, publication date or country of origin: EMBASE, MEDLINE, The Cochrane Library, Global Index Medicus, African Journals Online and SciELO. All peer-reviewed studies of primary data reporting management and outcomes of infant MMC-associated hydrocephalus will be included. Where high-quality homogeneous studies exist, meta-analyses will be conducted to compare the management and outcomes of MMC-associated hydrocephalus across socioeconomic and geographical regions of the world. The primary outcome will be treatment failure of the first-line hydrocephalus treatment, which we defined operationally as the performance of a second intervention for the same reason as the first. Secondary outcomes include time to failure, rates of mortality and postoperative complications.

ETHICS AND DISSEMINATION

Ethical approval was not applicable because this study does not involve human participants. Dissemination strategies will include publication in a peer-reviewed journal, oral and poster presentations at conferences and an interactive web application to facilitate interaction with the findings and promote the discussion and sharing of findings on social media.

PROSPERO REGISTRATION NUMBER

CRD42021285850.

摘要

简介

脑积水和脊髓脊膜膨出（MMC）在中低收入国家（LMICs）造成了不成比例的疾病负担。MMC 相关的脑积水及其后遗症导致了一系列严重的破坏性临床表现，而这些国家在人力、资本和技术资源方面准备不足。本研究旨在回顾和比较中低收入国家和高收入国家婴儿 MMC 相关脑积水的管理和结局。

方法和分析

本系统评价和荟萃分析将遵循 2020 年系统评价和荟萃分析的首选报告项目指南。将对以下数据库进行无限制的搜索，不限制语言、出版日期或来源国：EMBASE、MEDLINE、Cochrane 图书馆、全球索引医学、非洲在线期刊和 SciELO。所有纳入的研究均为报告婴儿 MMC 相关脑积水管理和结局的原始数据的同行评审研究。如果存在高质量的同质研究，将进行荟萃分析，以比较世界各地社会经济和地理区域 MMC 相关脑积水的管理和结局。主要结局将是一线脑积水治疗的治疗失败，我们将其操作定义为因同一原因对同一患者进行第二次干预。次要结局包括失败时间、死亡率和术后并发症发生率。