外翻式与补片式颈动脉内膜切除术近远期疗效的Meta分析

发布时间：2018-03-11 20:49

本文选题：颈动脉狭窄　切入点：颈动脉内膜切除　出处：《中国脑血管病杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的系统评价外翻式颈动脉内膜切除术(e CEA)与补片式CEA(p CEA)治疗颈动脉狭窄的近远期疗效。方法计算机搜索Medline、Pub Med、Ovid、CNKI及CBM数据库已发表的e CEA与p CEA对照研究的文献,时间为1970年5月至2016年10月。根据纳入和排除标准,由2名研究者选择文献,提取资料及数据,采用Cochrane协作网专用软件Rev Man 5.2对近远期疗效指标数据进行Meta分析。结果共检索出1 137篇文献,纳入10篇文献(其中3篇随机对照研究)进行分析,共计3 213例颈动脉狭窄患者,手术干预3 299例次(其中e CEA组1 512例次,p CEA组共1 787例次)。Meta分析结果显示,(1)e CEA组平均手术时间较p CEA组缩短(22±8)min,术中转流管使用率e CEA明显低于p CEA,分别为12.6%(53/421)和50.2%(357/711,OR=0.11,95%CI:0.08~0.15,P0.01)。术后30 d内卒中发生率(OR=0.42,95%CI:0.23~0.76,P=0.004)和30 d后卒中发生率(OR=0.26,95%CI:0.09~0.78,P=0.02)e CEA均低于p CEA,差异均有统计学意义(P0.05)。(2)e CEA降低了术后30 d后再狭窄发生率(OR=0.57,95%CI:0.38~0.86,P=0.008)。结论 e CEA治疗颈动脉狭窄较p CEA具有手术时间短、转流管使用率低的优势;同时e CEA能降低术后30 d内、30 d后卒中的发生,并且明显降低再狭窄发生率。
[Abstract]:Objective to systematically evaluate the short-term and long-term efficacy of varus carotid endarterectomy (CEA) and patch CEA(p CEA in the treatment of carotid artery stenosis. The time was from May 1970 to October 2016. According to the inclusion and exclusion criteria, two researchers selected literature, extracted data and data, The data of short-term and long-term curative effect were analyzed by Meta using Rev Man 5.2, a special software of Cochrane cooperation network. Results A total of 1,137 articles were retrieved, including 10 articles (3 randomized controlled studies). A total of 3 213 patients with carotid artery stenosis were analyzed. The results of Meta-analysis showed that the average operation time in the CEA group was 22 卤8 minutes shorter than that in the p CEA group, and the utilization rate of bypass tube e CEA was significantly lower than that in the pCEA group (12.6% 53 / 421, respectively) and 3 299 times of operation intervention (1 512 cases in the e CEA group) were compared with that in the pCEA group. Meta-analysis showed that the mean operation time in the CEA group was 22 卤8 minutes shorter than that in the p CEA group. The incidence of stroke within 30 days after operation was 0.232.76% and 0.2695% respectively, and the CEA of 0.2695% was lower than that of pCEA. The difference was statistically significant (P 0.05. 0. 05. 2e CEA decreased the rate of restenosis 30 days after operation. Conclusion the treatment of carotid artery stenosis with e CEA has shorter operation time than that of p CEA, P < 0. 05. 2) the incidence rate of stroke is 0. 529. 5% and 0. 05% P 0. 01. The incidence of stroke is 0.380.866% P0. 008. Conclusion the treatment of carotid artery stenosis with e CEA has a shorter time than that of p CEA, and the difference is statistically significant (P 0. 05. 0. 05??? P = 0. 00795??? At the same time, e CEA could reduce the incidence of stroke and reduce the incidence of restenosis within 30 days after operation.
【作者单位】：南昌大学第二附属医院血管外科;
【分类号】：R651.1

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