静脉鼻腔支架用于自发骨底部脑脊液泄漏的管理:系统性审查和元分析
Jordan M Rasmussen1, Kautilya R Patel2, Daniel L Surdell2
1College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
概括
静脉鼻腔支架 (VSS) 对治疗自发性脑脊液 (CSF) 泄漏有希望,在解决相关的异常性脑内高血压 (IIH) 症状方面成功率很高.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
背景情况:
- 异常性内高血压 (IIH) 经常与自发性脑脊液 (CSF) 泄漏有关.
- 静脉鼻腔支架 (VSS) 是IIH的一种成熟治疗方法,促使人们对其对CSF泄漏的有效性进行研究.
研究的目的:
- 系统地评估静脉鼻支架 (VSS) 在管理自发的头骨底部脑脊液 (CSF) 泄漏方面的有效性.
- 为了确定治疗失败率和解决VSS后的异常性脑内高血压 (IIH) 症状.
主要方法:
- 在主要数据库 (EMBASE,MEDLINE,Scopus,Cochrane Library,Google Scholar) 中进行了系统的文献搜索.
- 包括涉及自发骨底部液泄漏的VSS的研究; 儿科,非英语和非自发病例被排除在外.
- 治疗失败 (持续或反复发生的脊髓泄漏) 是主要的结果指标.
主要成果:
- 分析了8项涉及62名患者的研究;平均年龄为51.9岁,女性占87.5%,肥胖率高 (BMI 33.9 kg/m2).
- 在74.6%的患者中存在IIH. 在41.9%的患者中,单独使用VSS,58.1%的患者使用手术修复.
- 总体治疗失败率为11.3%. 估计失败率仅为VSS的18.6-26.4%,为VSS加上手术修复的5.5-12.2%. 在IIH中,症状解消率为88.7%.
结论:
- 静脉鼻腔支架 (VSS) 证明了在管理自发的头骨底部CSF泄漏方面的潜力.
- 需要进一步的研究来确定VSS作为独立治疗与外科修复辅助的最佳指示,并确定成功的预测因素.
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