Abstract:

Objective To evaluate the effect of lumbar drainage (LD) on cerebral aneurysms subarachnoid hemorrhage (aSAH). Methods A randomized controlled trials (RCTs) of LD on cerebral aSAH were searched from PubMed, Cochrane Library, Elsevier Science Direct, Springer, China academic Journal full-text Database (CNKI),Wanfang, China Biomedical Literature Database (CBM), and other databases. Methodological quality of the included literatures were evaluated by using Cochrane Handbook for Systematic Reviews of Interventions, and Meta-analysis was performed by using RevMan 5.2 software. Results Totally 11 literatures were inclused,including 1216 patients.Meta-analysis results showed that in terms of efficacy and safety of clinical treatment for aSAH was better in continuous LD group (experimental group) than control group, the incidence of neurological impairment was lower than in control group (MD =0.33, 95%CI [0.21-0.51], P<0.01), and the incidence of cerebral vasospasm was lower than in control group (MD =0.20, 95%CI [0.12-0.34], P<0.01), the incidence of hydrocephalus was lower than in control group (MD =0.25, 95% CI [0.14-0.43], P<0.01), the mortality was lower than in control group (MD=0.40, 95%CI [0.23-0.70], P<0.01), but other adverse events were higher than those in control group (SMD=3.24, 95%CI [1.63-6.47], P=0.008). Conclusion The safety of continuous LD for aSAH in patients is better than other treatment methods. We need to consider the unsafety factors will lead to adverse events, due to lower methodology quality is in this literature, the efficacy and safety still need to be further verified.

Key words: subarachnoid hemorrhage, lumbar cistern drainage, meta analysis