影像导航脑肿瘤切除术的Me ta分析

摘要

Objective:We did a Meta-analysis to evaluate the effect of image-guided brain tumor resection and contrast traditional surgical treatment.Methods:We searched randomized controlled studies in PubMed,CBM,Co-chrane library,Web of Science database to November 15,2014.Using RevMan 5.3 software to analyze data.To calcu-late the odds ratio(OR)and 95%confidence intervals,test heterogeneity of source,use funnel plot to assess publication bias.Results:10 randomized controlled studies(RCT),a total of 669 patients,including image-guided surgery 329 cases,340 cases of traditional surgery.Meta-analysis showed that:Compared with traditional surgery,image-guided brain tumor resection total resection rate was higher,the low incidence of postoperative dysfunction,the difference was statistically significant(P<0.05).In total removal rate there was no significant difference(P>0.05)between differ-ent image navigation.But in terms of postoperative dysfunction,intraoperative MRI was superior to ultrasound,ultra-sound superior to DTI(P=0.02).Conclusion:Imaging navigation brain tumor resection compared to conventional surgery can improve the rate of total resection of the tumor,protect functional area,reduce the incidence of postopera-tive complications and improve the patient's life quality.%目的：通过 Meta分析评估不同影像导航脑肿瘤切除术和传统手术对比治疗的效果。方法：计算机检索 PubMed、CBM、Cochrane library、Web of Science 数据库至2014年11月15日，以获得有关不同影像导航脑肿瘤切除术的随机对照研究。采用 RevMan 5．3软件分析数据，计算比值比（OR）及95％的可信区间，检验异质性并寻找其来源，应用漏斗图评估发表偏倚。结果：总共纳入10篇随机对照研究（RCT），共计669例病人，其中影像导航手术者329例，传统手术者340例。Meta分析结果显示：与传统手术相比，影像导航切除脑肿瘤的全切率较高，术后功能障碍发生率减低，差异具有统计学意义（P＜0．05）。在全切率方面，不同影像导航之间无统计学差异（P＞0．05）。但在降低术后功能障碍方面，术中磁共振优于超声，超声优于弥散张量成像（DTI）（P＝0．02）。结论：影像导航脑肿瘤切除术相比传统手术可以提高肿瘤全切率，最大程度保护功能区，降低术后并发症发生率，从而提高患者生活质量。