静心室外置仍然是一个安全的手术替代水头症:一个系统性审查和元分析
Enrico Lo Bue1, Alberto Morello2, Jacopo Bellomo3,4
1Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", AOU Città della Salute e della Scienza di Torino, University Hospital, University of Turin, 10124, Turin, Italy.
Scientific reports
|August 8, 2024
概括
与心室外皮质神经突变 (VPS) 相比,用于脑水的心室外皮质神经突变 (VAS) 手术显示,与心室外皮质神经突变 (VPS) 相比,神经突变功能障碍的风险较低. 这两种技术都有类似的感染和修订风险,强调个性化患者护理.
科学领域:
- 神经外科 神经外科
- 医疗器械 医疗器械
- 基于证据的医学基于证据的医学.
背景情况:
- 水脑病的管理通常涉及到脑脊液 (CSF) 的转移.
- 腹腔关突变 (VPS) 是常见的,而腹腔关突变 (VAS) 在某些情况下使用.
- 有限的证据指导VAS和VPS之间的选择.
研究的目的:
- 系统地审查和元分析VAS与VPS对水头的有效性和安全性.
- 为了比较两种技术之间的分流功能障碍,感染,修订和死亡率.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括前性/后性研究和病例系列 (≥5名患者/组).
- 来自9项涉及3197名患者的研究数据的定量综合.
主要成果:
- VAS 显示,分流功能障碍/阻塞的风险显著降低 (OR 0.49).
- 在感染风险 (OR 1.02) 或修订风险 (OR 0.73,高异质性) 中没有显著差异.
- 死亡风险没有显著差异 (OR 1.93,高异质).
结论:
- VAS是水头症治疗的安全替代方案.
- 汽车系统可以降低分流器功能障碍/阻塞的风险.
- 患者特定的因素应指导VAS和VPS之间的选择.
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