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骨膜下/皮下引流与慢性硬膜下血肿的硬膜下引流:术后结局的荟萃分析。

Subperiosteal/subgaleal drainage vs. subdural drainage for chronic subdural hematoma: A meta-analysis of postoperative outcomes.

机构信息

Department of Neurosurgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China.

Department of Neurology, the Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian Province, China.

出版信息

PLoS One. 2023 Aug 1;18(8):e0288872. doi: 10.1371/journal.pone.0288872. eCollection 2023.

Abstract

BACKGROUND

Chronic subdural hematoma (CSDH) is commonly treated via surgical removal of the hematoma, placement of a routine indwelling drainage tube, and continuous drainage to ensure that the blood does not re-aggregate following removal. However, the optimal location for placement of the drainage tube remains to be determined.

OBJECTIVES

To aid in establishing a reference for selecting the optimal method, we compared the effects of different drainage tube placements on CSDH prognosis via a systematic review and meta-analysis of previous clinical studies.

DATA SOURCES

PubMed, Embase, and Cochrane databases.

STUDY ELIGIBILITY CRITERIA

We searched for clinical studies comparing the outcomes of subperiosteal/subgaleal drainage (SPGD) and subdural drainage (SDD) for CSDH published in English prior to April 1, 2022.

PARTICIPANTS

The final analysis included 15 studies involving 4,318 patients.

RESULTS

Our analysis of the pooled results revealed no significant differences in recurrence rate between the SDD and SPGD groups. We also observed no significant differences in mortality or rates of postoperative complications (infection, pneumocephalus, or epilepsy) between the SDD and SPGD groups.

CONCLUSIONS

These results suggest that the choice of SDD vs. SPGD has no significant effect on CSDH prognosis, highlighting SPGD as an alternative treatment option for CSDH.

摘要

背景

慢性硬脑膜下血肿(CSDH)通常通过手术清除血肿、放置常规留置引流管以及持续引流来治疗,以确保在移除后血液不会再次聚集。然而,放置引流管的最佳位置仍有待确定。

目的

通过对以往临床研究的系统回顾和荟萃分析,帮助确定选择最佳方法的参考,比较不同引流管放置位置对 CSDH 预后的影响。

数据来源

PubMed、Embase 和 Cochrane 数据库。

研究入选标准

我们检索了 2022 年 4 月 1 日之前发表的英文临床研究,比较了骨膜下/骨膜下引流(SPGD)和硬脑膜下引流(SDD)治疗 CSDH 的结果。

参与者

最终分析纳入了 15 项研究,涉及 4318 例患者。

结果

我们对汇总结果的分析显示,SDD 组和 SPGD 组之间的复发率没有显著差异。我们还观察到 SDD 组和 SPGD 组之间的死亡率或术后并发症(感染、气颅或癫痫)发生率也没有显著差异。

结论

这些结果表明,SDD 与 SPGD 的选择对 CSDH 的预后没有显著影响,提示 SPGD 是 CSDH 的一种替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e76/10393133/cb6de41e08c8/pone.0288872.g001.jpg

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