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慢性腹腔内血瘤的骨下/腹骨下排水与腹腔内排水:一个系统的审查和元分析

Lucimário de Carvalho Barros¹, Clarissa Avancini², Ricardo Queiroz Gurgel³

¹Department of Medicine, Federal University of Sergipe, Aracaju, Brazil. lucimariocarvalho@icloud.com.

Neurosurgical review

|May 23, 2025

概括

下/骨下排水 (SGPD) 与下排水 (SDD) 相比,显著减少慢性下血瘤 (cSDH) 的复发. 这次元分析发现,SGPD在预防手术后cSDH复发方面更有效,其他结果没有显著差异.

科学领域:

神经外科神经外科
临床流行病学临床流行病学
医疗技术评估医疗技术评估

背景情况:

慢性亚皮血瘤 (cSDH) 是一个日益关注的问题,特别是在老年人群中.
手术疏散是cSDH的标准治疗方法,排水管的放置对于防止复发至关重要.
在cSDH中进行手术排水的最佳位置仍然是正在进行的临床辩论的主题.

研究的目的:

为了进行一个比较的评价 subgaleal/subperiosteal排水 (SGPD) 与体内排水 (SDD) 技术.
评估SGPD和SDD在接受cSDH手术治疗的患者的疗效和安全性.
确定排水位对cSDH复发率和临床结果的影响.

主要方法:

一个系统的审查和元分析,遵循PRISMA指导方针和柯克兰手册.
搜索主要数据库 (PubMed,Embase,Scopus,Web of Science) 来进行SGPD和SDD的比较研究.
主要结果:复发率. 二级结局:临床结局 (mRS 0-3),死亡率和并发症 (感染,出血,肺脑病,发作). 使用Cochrane RoB 2和ROBINS-I工具进行偏差风险评估.

主要成果:

分析包括了21项研究,涉及6,430名患者.
下/骨下排水 (SGPD) 显示,与下排水 (SDD) 相比,复发率的统计显著降低 (RR = 0.87; p = 0.0317).
对于二次结果,包括死亡率,有利的临床结果和并发症率,SGPD和SDD之间没有发现显著差异.

结论:

下/骨下排水 (SGPD) 在减少手术治疗慢性下血瘤 (cSDH) 复发率方面似乎比下排水 (SDD) 更有效.
目前的证据显示,两种排水技术之间的死亡率,临床结果或并发症概况没有显著差异.
需要进一步进行高质量的研究,包括多中心临床试验,以验证这些发现,并为cSDH建立明确的最佳排水放置策略.

关键词:

慢性腹膜下血腫慢性腹膜下血腫排水系统排水系统进行元分析分析.在体内,体内部 (subdural).亚加利亚地区的亚加利亚地区在骨以下的钢铁.

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