• 1. Department of Neurosurgery Medicine, Suqian People's Hospital of Nanjing Drum Tower Hospital Group, Suqian 223800, China;
  • 2. Department of Nursing, First People's Hospital of Suqian, Suqian 223800, China;
ZHENGJing, Email: doctorzhengjing@163.com
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Objective To systematically review the efficacy between key hole approach versus large trauma craniotomy for patients with hypertensive intracerebral hemorrhage. Methods Such databases as The Cochrane Library (Issue 3, 2013), PubMed, EMbase, WangFang Data, CNKI and VIP was searched to identify randomized controlled trials (RCTs) on key hole approach versus large trauma craniotomy for patients with hypertensive intracerebral hemorrhage from January 2005 to June 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2. Results A total of 13 studies involving 1 324 patients was included. The results of meta-analysis showed that, key hole approach was superior to large trauma craniotomy with significant differences in the fatality rate (OR=0.29, 95%CI 0.19 to 0.45, P < 0.000 01), incidence of postoperative complications (OR=0.35, 95%CI 0.21 to 0.57, P < 0.000 1), recovery time of consciousness (MD=-4.52, 95%CI-5.84 to-3.20, P < 0.000 01), neurologic impairment score after 1-month treatment (MD=-12.63, 95%CI-16.36 to-8.90, P < 0.000 01), total effectiveness (OR=3.79, 95%CI 2.54 to 5.66, P < 0.000 01), and postoperative living ability (ADL Grade I, Ⅱ). Conclusion Key hole approach is better than large trauma craniotomy for patients with hypertensive intracerebral hemorrhage. Due to limited quality and quantity of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality studies, especially conducting multicenter blinding RCTs with large sample-size.

Citation: LIJian, LIUWei, LUHai, ZHENGJing. Efficacy of Key Hole Approach versus Large Trauma Craniotomy for Hypertensive Intracerebral Hemorrhage: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(10): 1210-1217. doi: 10.7507/1672-2531.20140196 Copy

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