微创复合式冠状动脉血运重建术与冠状动脉旁路移植术临床结果的Meta分析

发布时间：2018-10-16 15:46

【摘要】：目的探讨微创复合式冠状动脉血运重建术(HCR)与传统冠状动脉旁路移植术(CABG)相比是否具备优越性。方法利用权威数据库EMBASE、PUBMED、CNKI检索相关文献,对比分析患者住院期间及1年死亡率、心肌梗死(MI)、休克、再次血运重建率、主要心脑血管不良事件等主要临床结果及输血、出血、心房颤动、肾衰竭等患者次要临床结果情况。结果 14个观察性研究(2个病例对照研究,12个倾向匹配研究),包括6685例患者:848例(12.68%)患者接受HCR,5837例(87.31%)接受CABG治疗。HCR在住院时间(WMD-0.87 h,95%CI-1.78~0.04,P0.0001)、心房颤动(RR 0.93,95%CI 0.22~3.89,P0.0001)、输血率(RR 1.04,95%CI 0.33~3.33,P0.0001)方面具有优势。在住院期间和1年随访中死亡率、心肌梗死、休克或再次行血运重建方面差异无统计学意义(P0.05)。结论 HCR对于将进行血运重建的冠状动脉病变是可行、安全、有效的手术方式。
[Abstract]:Objective to investigate the advantages of minimally invasive composite coronary artery revascularization (HCR) compared with traditional coronary artery bypass grafting (CABG). Methods EMBASE,PUBMED,CNKI was used to search the relevant literatures, and the main clinical results, blood transfusion and hemorrhage, such as mortality rate during hospitalization and 1 year, (MI), shock of myocardial infarction, re-revascularization rate, main adverse events of cardio-cerebral vessels, and so on, were compared and analyzed. Atrial fibrillation, renal failure and other patients with secondary clinical outcomes. Results there were 14 observational studies (2 case-control studies and 12 tendency matching studies), including 6685 patients (12.68%) received HCR,5837 treatment (87.31%). HCR had advantages in terms of hospitalization time (WMD-0.87 h95CI-1.780.04 P 0.0001), atrial fibrillation (RR 0.9395CI 0.223.89 P0.0001) and blood transfusion rate (RR 1.0495 CI 0.333.33 P0.0001). There was no significant difference in mortality myocardial infarction shock or revascularization during hospitalization and 1 year follow-up (P0.05). Conclusion HCR is feasible, safe and effective for coronary artery disease with revascularization.
【作者单位】：北京大学第三医院心脏外科;
【分类号】：R654.2

【相似文献】