经蝶窦入路与经颅手术治疗垂体脓肿疗效及安全性的Meta分析

Efficacy and safety of transsphenoidal surgery and transcranial surgery for pituitary abscess: a Metaanalysis

摘要:

目的比较经蝶窦入路手术（TSS）与经颅手术（TCS）方式治疗垂体脓肿（PA）的疗效及安全性。 方法计算机检索PubMed、Embase、the Cochrane library、中国生物医学文献（CBM）、中国知网（CNKI）、维普（VIP）、万方等中英文数据库有关TSS与TCS治疗PA的文献，检索时间至2020年1月。指标包括术后临床治愈、症状改善情况、并发症发生和远期复发率。最后使用RevMan5.3软件分析所提取数据。结果最终纳入11篇研究，共154例样本，125例接受TSS，29例接受TCS。分析结果显示TSS与TCS在术后疗效方面差异无统计学意义［RR=1.25,95%CI(0.90~1.74), P=0.19］；但与TCS组比，TSS可显著减少患者术后并发症发生率［RR=0.18, 95%CI(0.07~0.46), P<0.001］，降低术后复发风险［RR=0.38, 95%CI(0.21~0.68), P=0.001］，差异具有统计学意义。 结论与TCS相比，TSS治疗PA在疗效上无差异，但可显著降低术后并发症及复发风险。

Abstract:

Abstract:ObjectiveTo compare the efficacy and safety of transsphenoidal surgery(TSS) and transcranial surgery(TCS) for the treatment of pituitary abscess(PA).MethodsLiteratures related to TSS and TC for PA were searched by computer from PubMed, Embase, the Cochrane library, CBM, CNKI, VIP, Wanfang upto Jan 2020. The indexes included clinical cure, symptom improvement, complications and longterm recurrence rate. RevMan 5.3 software was used to analyze the extracted data.ResultsEleven studies with a total of 154 samples were included, Of all the cases, 125 were treated with TSS and 29 with TCS. Analyses revealed that there was no significant difference in the postoperative effect［RR=1.25,95%CI(0.90~1.74), P=0.19］between TSS and TCS, with significant reduction of postoperative complications［RR=0.18, 95%CI(0.07~0.46), P<0.001］and recurrence［RR=0.38, 95%CI(0.21~0.68), P=0.001］ in TSS.ConclusionCompared with TCS, TSS has no difference in efficacy for the treatment of PA, but it can significantly reduce the risks of postoperative complication and recurrence.