腹腔门外送与腹腔关节外送:一个系统的审查和元分析
Leonardo de Barros Oliveira1, Fernando Hakim2, Gabriel da Silva Semione3
1Department of Neurosurgery, State University of Ponta Grossa, Paraná, Ponta Grossa, Brazil.
Neurosurgery
|December 20, 2023
概括
腹腔外置 (VAS) 和腹腔皮质外置 (VPS) 的修订率,感染率和死亡率相似. 需要进一步的研究来澄清VAS与VPS在成年人中的特征.
科学领域:
- 神经外科 神经外科
- 医疗器械 医疗器械
- 系统审查是系统的审查.
背景情况:
- 腹腔皮突变 (VPS) 是标准的脑脊液突变程序.
- 由于有史以来的并发症,心室心腔突变 (VAS) 被认为是二线选择.
- 存在有限的可靠证据来比较VPS和VAS的疗效.
研究的目的:
- 进行一项元分析,比较心室腔门外分离器 (VAS) 和心室关节外分离器 (VPS).
- 评估VAS和VPS之间的修订,感染和与分流相关的死亡率的差异.
主要方法:
- 按照PRISMA指南进行系统的文献搜索.
- 包括比较VAS和VPS与修订,感染或死亡率的结果的研究.
- 16项涉及4304名患者 (1619名VAS,2685名VPS) 的研究的元分析.
主要成果:
- 在修复手术中没有发现VAS和VPS之间的显著差异 (RR = 1.10).
- 对于感染 (RR = 0.67) 或与分流相关的死亡率 (RR = 2.11) 没有发现显著差异.
- 最近的研究 (2000年以后) 表明没有与VAS相关的心肺并发症或死亡率.
结论:
- 在修订,感染和死亡率方面,VAS和VPS显示了可比的结果.
- 目前的文献已经过时,缺乏针对成人的具体研究.
- 未来的随机试验对于充分了解VAS的概况至关重要;临床决策应该是个性化的.
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