经导管自膨式和球囊扩张式主动脉人工瓣膜置入术疗效比较的Meta分析

发布时间：2018-04-08 11:27

本文选题：自膨式主动脉瓣膜　切入点：球囊扩张式主动脉瓣膜　出处：《实用医学杂志》2017年04期

【摘要】：目的:比较自膨式主动脉瓣膜(SEv)和球囊扩张式主动脉瓣膜(BEv)经导管主动脉瓣膜置入术(TAVI)的疗效及安全性,为临床治疗提供循证学依据。方法:检索Pubmed、CNKI和万方数据库,检索所有比较经导管SEv和BEv人工瓣膜置入术疗效的对照研究。统计分析30 d的病死率、中重度主动脉瓣返流(AR)、心脏起搏器植入率及随访1年的总体病死率,并采用Rev Man5.2和Stata11软件进行Meta分析。结果:最终纳入6项研究(1项为随机对照研究,5项为回顾性研究),共1 805例患者。分析结果显示,SEv置入术的中重度主动脉瓣返流率及心脏起搏器植入率均明显高于球囊扩张式瓣膜置入术(OR=3.01,P0.000 1;OR=4.13,P0.000 01),而二者的瓣膜置入术成功率、血管并发症发生率、30 d及1年病死率则无明显差异(P0.05)。结论:经导管SEv置入术中重度主动脉瓣返流率及心脏起搏器植入率风险高于BEv置入术,但二者的手术成功率、术后血管并发症发生率及中短期死亡率则无明显差异。
[Abstract]:Objective: to compare the efficacy and safety of self-expandable aortic valvus (SEV) and balloon dilated aortic valve (BEvV) via catheterized aortic valve implantation (TAVI), and to provide evidence based basis for clinical treatment.Methods: the database of Pubmedus Sinica and Wanfang were searched, and all the comparative studies were conducted to compare the efficacy of transcatheter SEv and BEv prosthetic valve implantation.The mortality of 30 days, moderate and severe aortic regurgitation, cardiac pacemaker implantation rate and overall fatality rate of 1 year follow up were analyzed statistically. Meta was analyzed by Rev Man5.2 and Stata11 software.Results: a total of 1 805 patients were included in 6 studies, including 1 randomized controlled study and 5 retrospective studies.The results showed that the moderate and severe aortic regurgitation rate and pacemaker implantation rate in SEV implantation were significantly higher than those in ORV 3.01 P 0.000 1 P 0.13 P 0.000 01, and the successful rate of valve implantation in both groups was higher than that in the balloon dilated valve implantation.There was no significant difference in the incidence of vascular complications between 30 days and 1 year (P 0.05).Conclusion: the risk of severe aortic regurgitation rate and pacemaker implantation rate in transcatheter SEv implantation is higher than that in BEv implantation, but there is no significant difference in the success rate, the incidence of postoperative vascular complications and the medium and short term mortality between the two groups.
【作者单位】：河南科技大学临床医学院河南科技大学第一附属医院心外科;
【分类号】：R654.2

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