急性与慢性Stanford B型主动脉夹层腔内修复术临床对比的Meta分析

发布时间：2018-04-29 14:40

  本文选题：急性与慢性 + Stanford　； 参考：《兰州大学》2017年硕士论文

【摘要】：目的利用系统评价的方法比较对急性与慢性Stanford B型主动脉夹层实施腔内修复术(TEVAR)的临床特点,研究Stanford B型主动脉夹层腔内修复术不同手术时机的临床特点,为今后的临床诊治方面提供参考。方法计算机检索检索维普中文科技期刊全文数据库(VIP)、中国知识资源总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、Google学术搜素、Pubmed、德国Springer、Web of Science、Embase、Cochrane图书馆资料库。有关急性与慢性Stanford B型主动脉夹层腔内修复术对比研究文献,采用RevMan5.3软件进行Meta分析。结果共纳入15篇符合标准的文献,其中英文文献7篇,中文文献8篇,共包括2295例患者,其中急性期1368例,慢性期927例。通过Meta分析后结果如下:与慢性期相比,急性期患者下肢及脏器缺血发生率更高(OR=2.32,95%CI:1.60,3.38,P0.05),胸腔积液发生率更高(3.66,95%CI:2.41,5.56,P0.05),术后发生逆撕形成A型主动脉夹层概率更高(OR=3.73,95%CI:1.26~11.4,P0.05),术后1~3年死亡率更高(OR=2.17,95%CI:1.35,3.50,P0.05),术后支架近端主动脉假腔血栓化发生率更高(OR=1.79,95%CI:1.16~2.76,P0.05),术后支架远端假腔血栓化发生率更高(OR=1.87,95%CI:1.29~2.69,P0.05);两组高血压,肾功能不全,术后发生内漏,截瘫无统计学意义(P≥0.05)。结论Stanford B型主动脉夹层急性期患者与慢性期患者相比术前并发症更多,术后死亡率及并发症更高,但是术后假腔血栓化发生率急性期患者高于慢性期患者。
[Abstract]:Objective to compare the clinical features of endovascular repair of acute and chronic Stanford B aortic dissection by means of systematic evaluation, and to study the clinical characteristics of Stanford B aortic dissection at different times. To provide reference for clinical diagnosis and treatment in the future. Methods A computer search was conducted for the full text database of Chinese scientific and technological journals in Weipu, CNKII, Wanfang, CBM, Pubmedand SpringerWeb of Science and Technology, and Cochrane Library in Germany. The literature on endovascular repair of acute and chronic Stanford B aortic dissection was analyzed by RevMan5.3 software. Results A total of 15 articles were included, including 7 in Chinese and 7 in Chinese, including 2295 patients, including 1368 in acute stage and 927 in chronic stage. The results of Meta analysis are as follows: compared with chronic stage, In acute stage, the incidence of lower limbs and viscera ischemia was higher than that of patients with acute stage. CI1: 1.603.38% P0.05, the incidence of pleural effusion was higher than 3.661% CI2.41% 5.56% P0.05, the probability of type A aortic dissection was higher after operation, the mortality rate was higher in 1 ~ 3 years after operation. The mortality rate was higher than that of 1.1795 CI-1 1.353.50% (P0.05), and the proximal end of stents had a higher probability of aortic dissection. The incidence of embolization was higher than 1.79% and 95% CI: 1.162.76% P0.05, and the incidence of thrombus in the distal end of the stent was higher than 1.8795% CI: 1.292.69% P0.050.The two groups had high blood pressure. Renal insufficiency, postoperative internal leakage, paraplegia had no statistical significance (P 鈮，

本文编号：1820363