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目的:评估术前栓塞辅助治疗脑膜瘤的效果。方法:检索PubMed、Web of science、中国知网、万方、维普等数据库从建库至2017年4月所纳入的有关术前栓塞联合手术治疗与单纯手术治疗脑膜瘤的随机对照研究(无论是否采用盲法)论文。采用Revman 5.3软件进行Meta分析。结果:本次共纳入论文17篇,涉及患者1262例。Meta分析结果显示,术前栓塞组全切率显著高于术前未栓塞组[P<0.05,比值比(OR)=3.58,95%CI为2.42~5.30]。术前栓塞组手术时间较术前未栓塞组短,但差异不显著[P>0.05,加权均数(WMD)=-0.66,95%CI为-1.36~0.04]。术前栓塞组出血量非常显著少于术前未栓塞组(P<0.01,WMD=-242.06,95%CI为-325.76~-158.36)。漏斗图形右侧底部发生缺失,纳入研究可能存在发表偏倚。结论:术前栓塞辅助治疗脑膜瘤有利于提高肿瘤全切除率,减少术中出血量等。
Objective: To evaluate the effect of preoperative embolization in the treatment of meningioma. Methods: Randomized controlled trials of preoperative embolization combined with surgical treatment and meningioma alone were included in the database from PubMed, Web of science, CNKI, Wanfang, VIP and other databases (no matter whether Blind method) Papers. Meta-analysis was performed using Revman 5.3 software. Results: A total of 17 papers were included in the study, involving 1262 patients. The results of Meta analysis showed that the rate of preoperative embolization group was significantly higher than that of preoperative embolization group [P <0.05, OR = 3.58, 95% CI 2.42-5.30]. The preoperative embolization group had shorter operative time than the preoperative embolization group, but the difference was not significant [P> 0.05, weighted mean (WMD) = -0.66, 95% CI -1.36 ~ 0.04]. Preoperative embolization group bleeding was significantly less than preoperative non-embolization group (P <0.01, WMD = -242.06, 95% CI -325.76 ~ -158.36). Missing to the right bottom of the funnel pattern may include publication bias. Conclusion: Preoperative embolization assisted meningioma is helpful to improve the total resection rate and reduce the intraoperative blood loss.