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华西医学  2011 

手术和伽马刀治疗较小听神经瘤的Meta分析

, PP. 679-683

Keywords: 听神经瘤,手术,伽马刀,Meta分析

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Abstract:

【】 目的 比较手术及伽马刀治疗<3cm听神经瘤的优劣。 方法 由2名研究人员分别检索1990年1月1日―2010年3月31日四川大学网上图书馆CENTRAL、ISI、Medline、Embase、NLMGateway、CBMdisc等数据库的相关论文,选择证据级别最高的文献,使用Cochrane图书馆提供的RevMan5.0软件,对手术和伽马刀治疗小型听神经瘤在面神经、听力功能保留的优劣方面进行Meta分析。 结果 共检索到4篇前瞻性队列研究,排除2篇。剩余的2篇文献共纳入患者173例,分析发现,在1年随访及随访结束时,手术治疗组与伽马刀治疗组相比,在面神经功能完整保留方面,P值及其95%CI分别为0.64(0.53,0.77)、0.67(0.47,0.96);在保留有用听力方面,P值及其95%CI分别为0.08(0.02,0.27)及0.08(0.02,0.28)。 结论 伽马刀治疗<3cm的听神经瘤,无论在保留有用听力还是面神经功能方面均明显优于手术。【Abstract】 Objective Tocomparesurgeryandgamma-knifetreatmentintreatingacousticneuromalessthan3cmindiameterthroughMetaanalysis. Methods TworesearchersrespectivelysearchedrelevantpapersfromsuchdatabasesasCENTRAL,ISI,Medline,Embase,NLMGateway,andCBMdiscpostedontheonlinelibraryofSichuanUniversity.Paperswiththehighest-gradeevidencewereselected,andRevMan5.0providedbyCochraneLibrarywasusedtocomparesurgeryandgamma-knifetreatmentinthepreservationofpatients’facialnervesandusefulhearingthroughMetaanalysis. Results Fourprospectivecohortstudieswerefound,twoofwhichwereexcluded.Theremainingtwoarticleswereanalyzed,andwecomparedsurgeryandgamma-knifetreatmentduringthe1-yearandthelastfollow-upperiodinfacialnervepreservationandusefulhearingpreservation.ThePvalueand95%CIofthecomparisonwasrespectively0.64(0.53,0.77)and0.67(0.47,0.96)forfacialnervepreservation,and0.08(0.02,0.27)and0.08(0.02,0.28)forusefulhearingpreservation. Conclusion Gamma-knifetreatmentforacousticneuromalessthan3cmindiameterisamuchbetterchoicethansurgeryinpreservinghearingandfacialnervefunction.

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