术前持续服用抗血小板药物对颈动脉内膜剥脱术术后出血影响的Meta分析

发布时间：2018-04-04 07:25

  本文选题：颈动脉内膜剥脱　切入点：抗血小板　出处：《临床麻醉学杂志》2017年05期

【摘要】：目的采用Meta分析比较颈动脉内膜剥脱术(carotid endarterectomy,CEA)患者术前持续服用抗血小板药物对术后出血的影响。方法检索Pubmed、Cochrane Library、Embase数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库和维普期刊网,时间从建库至2017年2月。收集所有关于术前服用抗血小板药物与CEA术后出血的随机对照试验(RCT)研究。采用Cochrane协作网系统评价法评价文献质量,采用RevMan 5.3软件对收集患者资料进行Meta分析评价。结果最终纳入4篇RCT,共514例患者,其中安慰剂组256例,干预组258例。所有结局指标各项研究结果无异质性(P0.1,I250%),采用固定效应模型分析。CEA术前持续服用抗血小板药物可明显降低CEA术后脑卒中风险(RR=0.30,95%CI 0.11~0.83,P=0.02)。两组术后30d(RR=0.23,95%CI 0.04~1.32,P=0.1)及1年全因死亡率(RR=0.49,95%CI 0.24~1.02,P=0.06)、大出血发生率(RR=1.40,95%CI 0.54~3.59,P=0.49)和出血并发症发生率(RR=1.02,95%CI0.15~6.96,P=0.98)及TIA发生率(RR=1.08,95%CI 0.47~2.49,P=0.86)差异无统计学意义。结论颈动脉内膜剥脱术前持续服用阿司匹林不增加术后出血并发症风险,但可明显降低术后脑卒中风险。
[Abstract]:Objective to compare the effect of continuous anti-platelet drugs on postoperative bleeding in patients with carotid endarterectomy by Meta analysis.Methods We searched the Pubmedan Cochrane Library Embase database, CNKIN, CBMN, Wanfang database and Weipu Journal Network, from the time of establishment to February 2017.All randomized controlled trial RCTs about preoperative antiplatelet drugs and postoperative bleeding after CEA were collected.The literature quality was evaluated by Cochrane system evaluation method and Meta analysis and evaluation by RevMan 5.3 software.Results A total of 514 patients were included in 4 RCTs, including 256 patients in placebo group and 258 patients in intervention group.According to the fixed effect model analysis, continuous administration of antiplatelet drugs before and after CEA could significantly reduce the risk of stroke after CEA.涓ょ粍鏈�鍚�30d(RR=0.23,95%CI 0.04~1.32,P=0.1)鍙，

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