非体外循环下冠状动脉搭桥术和体外循环下冠状动脉搭桥术远期并发症比较的Meta分析

发布时间：2019-01-02 09:02

【摘要】：目的:比较非体外循环下冠状动脉搭桥术(OPCABG)和体外循环下冠状动脉搭桥术(ONCABG)的远期并发症。方法:计算机检索中国知网、万方、维普、PubMed、EMBASE、Cochrane图书馆等数据库,查找关于非体外循环下冠状动脉搭桥术和体外循环下冠状动脉搭桥术的随机对照试验(RCT),按Cochrane系统评价方法,对通过纳入与排除标准的研究文献进行质量评价,并提取有效数据后采用RevMan5.2软件进行meta分析。结果:共纳入9个研究,11 660例患者,其中非体外循环组5 794例,体外循环组5 866例。Meta分析结果显示非体外循环下冠状动脉搭桥术和体外循环下冠状动脉搭桥术远期死亡率接近,差异无统计学意义[OR=1.10,95%CI(0.94,1.30),P=0.22];远期心肌梗死率接近,差异无统计学意义[OR=0.90,95%CI(0.76,1.06),P=0.21];远期血运重建率有差异,体外循环下冠状动脉搭桥术的远期血运重建率低于非体外循环下冠状动脉搭桥术,差异有统计学意义[OR=1.41,95%CI(1.09,1.83),P=0.009];远期脑卒中率有差异,非体外循环下冠状动脉搭桥术的远期脑卒中率低于体外循环下冠状动脉搭桥术,差异有统计学意义[OR=0.75,95%CI(0.57,0.98),P=0.04]。结论:非体外循环下冠状动脉搭桥术和体外循环下冠状动脉搭桥术的远期并发症发生率中死亡率、心肌梗死差异不大,而脑卒中、血运重建具有显著差异。证据显示体外循环下冠状动脉搭桥术有效降低患者远期血运重建的发生,而非体外循环下冠状动脉搭桥术有效降低患者远期脑卒中的发生。
[Abstract]:Objective: to compare the long-term complications of off-pump coronary artery bypass grafting (OPCABG) and cardiopulmonary bypass coronary artery bypass grafting (ONCABG). Methods: to search the databases of China Zhiwang, Wanfang, Weip, PubMed,EMBASE,Cochrane library, and to find out the randomized controlled trial (RCT),) about off-pump coronary artery bypass grafting and coronary artery bypass grafting under cardiopulmonary bypass. According to the evaluation method of Cochrane system, the quality of the research literature which includes and excludes the standard is evaluated, and the valid data are extracted and analyzed by RevMan5.2 software. Results: 11 660 patients, including 5 794 cases in the off-pump group, were included in 9 studies. The results of Meta analysis showed that the long-term mortality of off-pump coronary artery bypass grafting and cardiopulmonary bypass coronary artery bypass grafting was similar, and there was no significant difference [OR=1.10,95%CI (0.94 卤1.30), P < 0.22]. The rate of long-term myocardial infarction was close, the difference was not statistically significant [OR=0.90,95%CI (0.76 卤1.06), P < 0.21]; The long-term revascularization rate of coronary artery bypass grafting under cardiopulmonary bypass was lower than that of off-pump coronary artery bypass grafting, and the difference was statistically significant [OR=1.41,95%CI (1.09 卤1.83), P0. 009]. The long-term stroke rate was significantly lower in off-pump coronary artery bypass grafting than in cardiopulmonary bypass coronary artery bypass grafting (OR=0.75,95%CI (0. 57 卤0. 98), P0. 04). Conclusion: the mortality of long-term complications in off-pump coronary artery bypass grafting and cardiopulmonary bypass coronary artery bypass grafting has no significant difference in myocardial infarction, but there is significant difference in stroke and revascularization. Evidence shows that coronary artery bypass grafting under cardiopulmonary bypass can effectively reduce the occurrence of long-term revascularization, while off-pump coronary artery bypass grafting can effectively reduce the incidence of long-term stroke.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R654.2

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