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目的:应用meta分析评价血流导向装置对大型或巨大型颅内动脉瘤的有效性和安全性。方法:检索Pubmed、Cochrane图书馆、Embase、Medline、中国知网(CNKI)、万方数据库和维普网建库以来至2020年2月使用血流导向装置治疗大型或巨大型颅内动脉瘤的相关文献。由2名研究员独立筛查、评选文献并提取所需数据。应用Stata 15软件进行meta分析，评价血流导向装置对大型或巨大型颅内动脉瘤的有效性和安全性。结果:共纳入10项研究，共648例患者和656个动脉瘤，其中5个动脉瘤为破裂动脉瘤，多发性动脉瘤均应用血流导向装置治疗。随访时间超过半年的动脉瘤完全闭塞率为74%[95%可信区间(confidence interval, n CI)71%～78%；n I2＝0.00%]，半年随访时动脉瘤完全闭塞率为67%(95% n CI 58%～76%；n I2＝63.03%)。动脉瘤占位效应引起症状的总体好转率为75%(95% n CI 52%～93%；n I2＝82.12%)。支架释放成功率为97%(95% n CI 93%～100%；n I2＝97.12%)。总体并发症、总体出血事件、总体缺血事件以及总体永久性脑神经功能损害发生率分别为12%(95% n CI 7%～18%；n I2＝74.12%)、4%(95% n CI 2%～7%；n I2＝43.93%)、8%(95% n CI 4%～12%；n I2＝60.12%)和3%(95% n CI 1%～7%；n I2＝66.83%)。出血事件和缺血事件导致的永久性脑神经功能损害发生率分别为1%(95% n CI 0%～2%；n I2＝25.86%)和2%(95% n CI 0%～5%；n I2＝48.15%)。半年以上随访时改良Rankin量表评分为0～2分的患者比例为90%(95% n CI 84%～95%；n I2＝76.78%)，手术治疗相关病死率为2%(95% n CI 1%～3%；n I2＝17.24%)。n 结论:Meta分析结果显示，血流导向装置对大型或巨大型颅内动脉瘤的治愈率较高，总体安全性良好，但并发症仍是不可回避的问题。“,”Objective:To evaluate the efficacy and safety of flow diverter for large/giant intracranial aneurysms using a meta-analysis.Methods:PubMed, Cochrane Library, Embase, Medline, CNKI, Wanfang Data and VIP database were searched for relevant literatures on flow diverter for large/giant intracranial aneurysms from the establishment of the database to February 2020. Two researchers independently screened, selected the literature and extracted the required data. Stata 15 software was used for meta-analysis to evaluate the efficacy and safety of flow diverter for large/giant intracranial aneurysms.Results:A total of 10 studies were enrolled, including 648 patients with 656 aneurysms. Five of them were ruptured aneurysms. All the multiple aneurysms were treated with flow diverter. The complete occlusion rate of aneurysms with a follow-up time of more than half a year was 74% (95% confidence interval [n CI] 71%-78%; n I2=0.00%), and the complete occlusion rate of aneurysms with the half-year follow-up was 67% (95% n CI 58%-76%; n I2=63.03%). The overall improvement rate of symptoms caused by space-occupying effect was 75% (95% n CI 52%-93%; n I2=82.12%). The success rate of stent release was 97% (95% n CI 93%-100%; n I2=97.12%). The incidence of the overall complications, overall bleeding events, overall ischemic events, and overall permanent neurological impairment were 12% (95% n CI 7%-18%; n I2=74.12%), 4% (95% n CI 2%-7%; n I2=43.93%), 8% (95% n CI 4%-12%; n I2=60.12%), and 3% (95% n CI 1%-7%; n I2=66.83%), respectively. The incidence of permanent neurological damage caused by bleeding events and ischemic events were 1% (95% n CI 0%-2%; n I2=25.86%) and 2% (95% n CI 0%-5%; n I2=48.15%), respectively. The proportion of patients with the modified Rankin Scale score of 0-2 during follow-up for more than half a year was 90% (95% n CI 84%-95%; n I2=76.78%), and the surgical treatment-related mortality was 2% (95% n CI 1%-3%; n I2=17.24%).n Conclusion:Meta-analysis results showed that the flow diverter had a higher cure rate for large/giant intracranial aneurysms, and the overall safety was good, but complications are still an unavoidable problem.