The Effect of Locally Administered Fibrinolytic Drugs Following Aneurysmal Subarachnoid Hemorrhage : A Meta-Analysis with Eight Randomized Controlled Studies

摘要: OBJECTIVE Rapid dissolution of blood clots reduces vasospasm and hydrocephalus after subarachnoid hemorrhage (SAH), locally administered fibrinolytic drugs (LAFDs) could facilitate the dissolution. However, efficacy LAFDs remains controversial. The aim this meta-analysis was to determine for in clinical outcomes. METHODS From PubMed, EMBASE, Cochrane database, data were extracted by two authors. Meta-analysis performed using a random effect model. Inclusion criteria patients who had with urokinase-type or recombinant tissue-plasminogen activator SAH comparison medically untreated drugs. We only included randomized controlled trials (RCTs) analysis. outcomes interest vasospasm, hydrocephalus, mortality, 90-day unfavorable functional outcome. RESULTS Data from eight RCTs 550 included. Pooled-analysis revealed that significantly associated lower rates (LAFDs group vs. control group, 26.5% 39.2%; odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32-0.73); 26.0% 31.6%; OR, 0.54; CI, 0.32-0.91); mortality 10.5% 15.7%; 0.58; 0.34-0.99). proportion 32.7% 43.5%; 0.55; 0.37-0.80). CONCLUSION This indicated SAH. Thus, consequently reduce improve outcome