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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、NLM Gateway、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RevMan 5.0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,RR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,RR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。
Objective To compare the advantages and disadvantages of surgery and gamma knife treatment of <3cm acoustic neuroma. Methods Two researchers retrieved the related articles in databases such as CENTRAL, ISI, Medline, Embase, NLM Gateway and CBMdisc from January 1, 1990 to March 31, 2010 respectively, and selected the documents with the highest level of evidence , Using the RevMan 5.0 software available from the Cochrane Library to perform Meta-analysis of surgeries and gamma knife treatment of small acoustic neuromas on the pros and cons of facial nerve and preservation of hearing function. Results A total of 4 prospective cohort studies were retrieved, excluding 2 articles. The remaining two articles enrolled a total of 173 patients, the analysis found that at 1-year follow-up and follow-up, surgical treatment group compared with the gamma knife treatment group, facial nerve function in intact, the RR value and 95% CI 0.67 (0.47, 0.96). The RR and its 95% CI were 0.08 (0.02,0.27) and 0.08 (0.02,0.28), respectively. Conclusion The treatment of acoustic neuroma <3cm by Gamma knife is better than surgery in retaining useful hearing and facial nerve function.