Chiari I畸形2种手术方式疗效比较的Meta分析

目的 系统评价单纯后颅窝减压术和后颅窝减压术加硬脑膜成形术在治疗Chiari I畸形并脊髓空洞的临床疗效。方法 检索PubMed、OVID、万方数据库、中国知网、维普中文数据库，从建库到2015年12月收录的有关Chiari I畸形治疗的随机对照研究文献，采用RevMan5.2软件进行meta分析。结果 后颅窝减压术加硬脑膜成形术手术组在脊髓空洞缩小率（OR=0.22，95% CI：0.12~0.42，P<0.001）及症状改善率（OR=0.11，95% CI：0.05~0.23，P<0.001）方面优于单纯后颅窝减压术手术组，差异具有统计学意义；术后早期并发症发生率（OR=0.62，95% CI：0.17~2.29，P>0.05），差异无统计学意义。结论 在治疗Chiari I畸形并脊髓空洞的手术方式中，后颅窝减压术加硬脑膜成形术的脊髓空洞缩小率及临床症状改善率优于单纯后颅窝减压术。

A Meta-analysis of two surgical methods in treatment of Chiari I malformation with syringomyelia

Objective To systematically review the clinical curative effect of foramen magnum decompression with and without duraplasty in the treatment of Chiari I malformation with syringomyelia. Methods The follow-up randomized controlled studies ofChiari I malformationwere performed by the retrieval of PubMed, OVID, Wanfang Database, CNKI and VIP database from their building time to the year 2015. Meta analysis was performed using revman5.2 software. Results Syringomyelia reduction rateOR=0.20,95%CI (0.11-0.39),P=0.11]and the clinical improvement rateOR=0.11,95%CI(0.05-0.23),P=0.79] of foramen magnum decompression with duraplasty group were better than those of foramen magnum decompression without duraplasty group, and the difference was statistically significant. There were no statistical differences in early postoperative complication rateOR=0.62,95%CI(0.17-2.29),P=0.71]. Conclusion The perspective of the existing clinical evidence, surgical methods in the treatment of Chiari I malformation with syringomyelia in FMDD is superior to that of FMD in terms of the syringomyelia reduction rate and the clinical improvement rate.