摘要目的 评价控制减压治疗重型颅脑损伤对迟发颅内血肿、急性脑膨出、脑梗死等严重并发症的影响. 方法 检索Pubmed、Cochrane、万方数据库、维普数据库、中国知网数据库关于控制减压(治疗组)和常规手术(对照组)治疗重型颅脑损伤的相关文献,提取符合入选标准文献中的数据,用Review Manager 5.3软件对数据进行统计分析. 结果 最终12篇文献纳入研究,对照组和治疗组分别为730例、908例颅脑损伤患者.控制减压治疗减少了颅内迟发血肿的发生(RR =0.55,95％CI 0.44 ～0.70,P＜0.01);降低了术中急性脑膨出发生概率(RR =0.42,95％ CI0.32 ～0.53,P＜0.01);减少了术后脑梗死事件(RR =0.42,95％ CI 0.32～0.55,P＜0.01). 结论 术中控制减压较手术方法治疗重型颅脑损伤患者可明显降低术中迟发血肿、急性脑膨出,以及术后脑梗死等严重并发症的发生.

abstractsObjective To evaluate the effect of controlled decompression on complications such as delayed intracranial hematoma,acute encephalocele and cerebral infarction in patients with severe traumatic brain injury.Methods Pubmed,Cochrane Library,Wanfang data,VIP and CNKI wcrc searched for related literaturc about controlled decompression (treatment group) and traditional surgical methods(control group) for severe traumatic brain injury.The data that met the inclusion criteria were extracted,and analyzed statistically using the Review Manager 5.3.Results A total of 12 studies were included in this meta-analysis,with respective 730 patients in control group and 908 patients in treatment group.Controlled decompression versus traditional treatment methods reduced incidence of delayed intracranial hematoma (RR =0.55,95％ CI 0.44-0.70,P ＜ 0.01),acute encephalocele(RR =0.42,95％ CI 0.32-0.53,P ＜ 0.01) and cerebral infarction (RR =0.42,95％ CI 0.32-0.55,P ＜0.01).Conclusion Applied to treat severe traumatic brain injury,controlled decompression exhibit significantly lower rate of delayed intracranial hematoma,acute encephalocele and cerebral infarction than traditional methods.