中国完全胸腔镜下二尖瓣置换术与开胸二尖瓣置换术治疗的Meta分析

发布时间：2018-05-22 15:35

  本文选题：完全胸腔镜 + 传统开胸　； 参考：《山西医科大学》2017年硕士论文

【摘要】：研究目的:对我国在完全胸腔镜下二尖瓣置换术与正中开胸二尖瓣置换术的临床效果进行比较,从而为心脏瓣膜置换术手术方式选择提供更加优化的思路,以进一步提高术后患者生活质量,使心脏瓣膜病患者得到更佳的治疗方法,促进我国心脏外科手术技术向前发展。研究方法:通过对万方数据库、维普数据库、中国知网、中国生物医学数据库中2000年到2016年发表的医学文献进行检索,收集关于完全胸腔镜下与正中开胸二尖瓣置换术对比的有关文章,按照制定的纳入、排除标准,最终将7篇符合标准的相关文献纳入研究,将所有筛选出的文献的质量进行评价,对文献中有关手术时间、术中体外循环时间、术中升主动脉阻断时间、术后呼吸机使用时间、术后ICU监测时间、术后胸腔引流量、术后并发症发生率及术后住院时间的对比数据进行提取,使用RevMan 5.0软件行Meta分析。结果:最终共有7篇文献被纳入分析研究,总病例数为781例,其中施行完全胸腔镜下二尖瓣置换术者367例,正中开胸二尖瓣置换术者414例。Meta分析提示:两组升主动脉阻断时间[WMD=5.86,95%CI(0.18,11.53),P=0.04],术后呼吸机使用时间[WMD=-2.07,95%CI(-3.71,-0.44),P=0.01],术后胸腔引流量[WMD=-66.57,95%CI(-119.49,-13.66),P=0.01],术后ICU监测时间[WMD=-3.57,95%CI(-6.08,-1.05),P=0.006],术后住院时间[WMD=-3.01,95%CI(-4.52,-1.50),P0.0001],术后并发症发生率[OR=0.44,95%CI(0.25,0.79),P=0.005]比较,差异有统计学意义;体外循环时间[WMD=5.35,95%CI(-0.89,11.59),P=0.09],总体手术时间[WMD=0.06,95%CI(-0.25,0.36),P=0.71]比较,差异无统计学意义。结论:在术后胸腔引流量、术后呼吸机使用时间、术后ICU监测时间、术后住院时间、术后并发症发生率方面,完全胸腔镜下二尖瓣置换术组整体均明显低于正中开胸二尖瓣置换术组,但完全胸腔镜下二尖瓣置换术的升主动脉阻断时间长于正中开胸二尖瓣置换术。两者的总体手术时间和术中体外循环时间无明显差异。
[Abstract]:Objective: to compare the clinical effect of mitral valve replacement under complete thoracoscopic surgery with that of middle thoracotomy mitral valve replacement in China, so as to provide a more optimized method for heart valve replacement. In order to further improve the quality of life of postoperative patients, so that patients with cardiac valve disease to get a better treatment, promote the development of cardiac surgery technology in China. Methods: the medical literature published from 2000 to 2016 in Wanfang Database, Weipu Database, China knowledge Network and China Biomedical Database were searched. To collect relevant articles on the comparison between complete thoracoscopic and median thoracotomy mitral valve replacement, and according to the established inclusion and exclusion criteria, finally include 7 relevant articles that meet the criteria in the study. The quality of all the selected literatures was evaluated. The operative time, the time of extracorporeal circulation, the time of ascending aorta occlusion, the time of ventilator use after operation, the monitoring time of postoperative ICU, the postoperative drainage volume of thoracic cavity were evaluated. The incidence of postoperative complications and postoperative hospitalization time were extracted and Meta analysis was performed with RevMan 5.0 software. Results: a total of 7 articles were included in the study. The total number of cases was 781, of which 367 underwent complete thoracoscopic mitral valve replacement. 姝ｄ腑寮，

本文编号：1922657