A Meta-analysis About Hydrocephalus:Ventriculo-peritoneal Shunt Vs Ventriculo Sagittal Sinus Shunt

Objective: In order to obtain more objective results and provide guidance for physicians in the clinical diagnosis and treatment of hydrocephalus.Methods: We search all of English and Chinese databases,such as English databases Pub Med,Cochrane Library,Embase,etc,Chinese databases such as Wanfang Medical Network,China How Net,and Chinese Biomedical Literature Database,and collect related conference papers and unpublished papers.Retrieve relevant Chinese and English literatures on the ventricular sagittal sinus shunt published in the database until March 2020.The documents were screened in layers according to the set inclusion criteria and corresponding exclusion criteria.The quality of the included literature was evaluated according to the Newcastle-Ottawa Scale NOS.The meta-analysis was performed using Revman5.3 software.The data type of the included study was a binary variable.The evaluation index of the evaluation effect was based on the RR value and 95% CI,and funnel plots were used for publication bias analysis of selected literatures.Results:A meta-analysis was performed on 12 studies including 835 patients finally,There are 418 patients in the ventriculoperitoneal shunt group and 417 patients in the ventricular sagittal sinus shunt group.Meta analysis results show that: in terms of objective remission rate,compared with the ventricular-abdominal shunt group and the ventricular sagittal sinus-shunt group:(0R = 1.08,95% CI: [0.74,1.56],P = 0.69),there is no statistical difference significance.In terms of side effects,the incidence of intracranial hematoma after operation:(0R = 1.19,95% CI: [0.52,2.70],P = 0.68),the difference was not statistically significant.Postoperative shunt system infection rate:(0R = 1.97,95% CI: [1.03,3.80],P = 0.04);Probability of shunt system obstruction:(0R = 2.03,95% CI: [1.06,3.87],P = 0.03);secondary surgery rate(0R = 1.79,95% CI: [1.13,2.84],P = 0.01),the differences were statistically significant.Conclusion: 1.The effect of ventriculoperitoneal shunt and ventricular sagittal sinus shunt on hydrocephalus is equivalent.2.Ventricular sagittal sinus shunting does not increase the incidence of intracranial hematomas compared to ventriculoperitoneal shunting.3.Ventricular sagittal sinus shunt can reduce the incidence of infection,obstruction and secondary surgery after shunt.