Liu Hou-Qiang, Bai Xue, Xiong Fang-Ling, Gao Ming-Ming, Zhang Huai-Bing, Liu Bao-Hua
Department of Neurosurgery, the Affiliated Suqian Hospital of Xuzhou Medical University Or Suqian Hospital of Nanjing Drum Tower Hospital Group, SuqianJiangsu Province, 223800, China.
Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221000, China.
Chin Neurosurg J. 2024 Oct 9;10(1):28. doi: 10.1186/s41016-024-00380-5.
Chronic subdural hematoma (CSDH) is one of the most common diseases in neurosurgery. It is the result of chronic intracranial hemorrhage that converges between the dura mater and arachnoid three weeks after externally injuring the head. Chronic subdural hematomas are a common complication in neurosurgery. With the gradual increase in the amount of hematoma, the surrounding brain tissue is pushed and compressed, resulting in corresponding clinical symptoms and signs. It is reported that the overall incidence rate of CSDH is 1.72 to 20.6 per 100,000 people every year, and the incidence rate of the elderly is particularly high.
The computer retrieves eight databases to obtain controlled trials at home and abroad on the effects of neuroendoscopy-assisted surgery in patients with chronic subdural hematoma. After a rigorous literature quality evaluation, data analysis was performed using RevMan 5.3 software.
Twenty studies were ultimately included in this meta-analysis. Seventeen studies reported the Recurrence rate of the test group and the control group, which was significantly lower (OR 0.27; 95% Cl 0.18, 0.38; P < 0.01) than the control group, Recovery rate (OR 1.18; 95% Cl 1.01, 1.38; P = 0.03), Total effective rate (OR 1.11; 95% Cl 1.04, 1.17; P < 0.01), Operative time (SMD 15.78; 95% Cl 9.69, 21.86; P < 0.01), Hospital stay (SMD - 1.66; 95% Cl - 2.17, - 1.14; P < 0.01) and Complications (OR 0.48; 95% Cl 0.30, 0.78; P < 0.01).
The results of this study suggest that neuroendoscopy-assisted surgery may be effective in patients with chronic subdural hematoma, as evidenced by recurrence rate, recovery rate, total effective rate, operative time, hospital stay, complications, and the above conclusions need to be verified by more high-quality studies.
慢性硬膜下血肿(CSDH)是神经外科最常见的疾病之一。它是头部外伤三周后硬脑膜和蛛网膜之间慢性颅内出血汇聚的结果。慢性硬膜下血肿是神经外科常见的并发症。随着血肿量逐渐增加,周围脑组织受到挤压,导致相应的临床症状和体征。据报道,CSDH的总体发病率为每年每10万人1.72至20.6例,老年人的发病率尤其高。
通过计算机检索八个数据库,获取国内外关于神经内镜辅助手术治疗慢性硬膜下血肿患者效果的对照试验。经过严格的文献质量评估后,使用RevMan 5.3软件进行数据分析。
本荟萃分析最终纳入20项研究。17项研究报告了试验组和对照组的复发率,试验组显著低于对照组(OR 0.27;95%CI 0.18,0.38;P<0.01),恢复率(OR 1.18;95%CI 1.01,1.38;P = 0.03),总有效率(OR 1.11;95%CI 1.04,1.17;P<0.01),手术时间(SMD 15.78;95%CI 9.69,21.86;P<0.01),住院时间(SMD -1.66;95%CI -2.17,-1.14;P<0.01)以及并发症(OR 0.48;95%CI 0.30,0.78;P<0.01)。
本研究结果表明,神经内镜辅助手术治疗慢性硬膜下血肿患者可能有效,从复发率、恢复率、总有效率、手术时间、住院时间、并发症等方面得以证明,上述结论有待更多高质量研究验证。