Meta-analysis Of Efficacy And Safety In Nimodipine Combined With Cerebrospinal Fluid Displacement In The Treatment Of Subarachnoid Hemorrhage In China

Background: Subarachnoid hemorrhage is a common type of hemorrhagic stroke, it’ s mortality and morbidity are higher than other types, and the trend of incidence has increased year hy year. Cerebral vasospasm (CVS) is a common and severe complications of spontaneous subarachnoid hemorrhage, and can cause serious local cerebral ischemia and delayed ischemic brain damage. CVS is the main cause of death and disability of the SAH patients Effective and reasonable treatment can improve the prognosis of SAH. Nimodopine has become the first choice to treat CVS. Cerebrospinal fluid displacement can not only direct removal of subarachnoid hemorrhage, dilute the bloody cerebrospinal fluid, reducing intracranial pressure, relieve symptoms such as headache, vomiting, and can eliminate vascular active substances, thereby reducing the occurrence of CVS. At present many scholars adopt the method of randomized controlled clinical for Nimodopine combined cerebrospinal fluid replacement for subarachnoid hemorrhage in clinical research, but there is too little content of sample, the research conclusions have differences. Meat-analysis is the statistical analysis of large collection of analysis results from individual studies for the purpose of integrating the findings. Using the Meta analysis method, can solve the above problem, get closer to the true results.Objective: To provide the basis of clinical usage of Nimodopine combined with cerebrospinal fluid displacement on spontaneous subarachnoid hemorrhage (SA11) through Meta—analysis. We use the meta-analysis methods to analyze collected data, system evaluation Nimodopine with cerebrospinal fluid replacement therapy efficacy and safety of spontaneous subarachnoid hemorrhage.Methods: First of all, Set a standard. Type must be clinical randomized controlled trials. The object of study is in1ine wi th the diagnostic critoria of adult patients. There must be death toll in the ending index. Search CNK1, WangFan Articles and VIP—related clinical trials to process data entry, index analysis, and publication bias.Results:Procedure data analysis on heterogeneity test showed no heterogeneity. In the fixed effects model merge, Meta-analysis confirmed that Nimodopine combined with cerebrospinal fluid displacement can reduce the number of occurrence of CVS after SAH and can not increase the rate of rehemorrhage. Dead rate of Nimodipine group was lower than the control group. Begg and Egger assay had prompted the study there was no obvious bias.Conclusion:The domestic clinical research evidence shows that Nimodipine combined with cerebrospinal fluid displacement is a safe and effective treatment of spontaneous subarachnoid hemorrhage. This research is secondary research, so the quality of it mainly depends on the quality of the original research article. There may be the following limitations. May not be the whole literature collection. Research design options in domestic research, so paper quality is not high, and results may be biased.The cause of the article publication bias is as follows. Positive results are more likely to be published; Literature collection standard differences; Curative effect judgment index of some of the choices are easy to appear positive results; Into the poor methodological quality of the research; The influence of the source of funds. At present due to various reasons, academic periodicals in China, the positive conclusion of the article published more easily. Therefore in this paper, the results may be biased.