ABSTRACT
Objective@#: Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. @*Methods@#: This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient’s age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. @*Results@#: This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40–0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24; 95% CI, 0.14–0.40; p=0.60; I2=0%) than in general patient population. @*Conclusion@#: The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.
ABSTRACT
Objective:To investigate the effect of Tiluo Yangxue Mingmu prescription on the improvement of visual function，and to analyze the effect on the vessel density and the thickness of retinal nerve fiber layer（RNFL） of optic nerve in glaucoma patients. Method:The clinical data of 234 eyes of 117 patients of primary glaucoma treated with Tiluo Yangxue Mingmu prescription from January 2017 to July 2020 were retrospectively analyzed. Fifty-seven eyes treated with the Tiluo Yangxue Mingmu prescription were reviewed as the treatment group，and 57 eyes that were not treated with the prescription matched in gender，age and course of treatment were selected as the control group. The changes of BCVA，mean sensitivity（MS） and mean deviation（MD） of visiual field before and after treatment were analyzed. Optical coherence tomography（OCTA） was used to analyze the changes of VD and thickness of RNFL of potic nerve before and after treatment. Result:After treatment，compared with that before treatment，BCVA was increased （P=0），MS was increased （P=0），MD was decreased（P=0.001），VD of the whole image（P=0），VD of the inside disc（P=0.004） and all subdivisions of peripapillary（P<0.05） was increased，the RNFL thickness（except inferior nasal area） was not significantly changed. After treatment，MS was increased（P=0.003） and MD was decreased（P=0.024） in treatment group compared with those before treatment. In the control group，there was no statistical difference in the changes of visual field indicators after treatment compared with that before treatment. Conclusion:For glaucoma patients whose intraocular pressure is stable within the range of target intraocular pressure，Tiluo Yangxue Mingmu prescription can improve the visual function and VD of optic nerve，but has no significant effect on RNFL thickness.