冷冻球囊消融与射频消融治疗阵发性心房颤动效果Meta分析

发布时间：2018-12-12 10:16

【摘要】：目的系统评价冷冻球囊消融(CBA)对比射频消融(RFA)治疗阵发性心房颤动(PAF)的临床效果。方法计算机检索Pub Med、EMbase、Cochrane Library、Web of Knowledge、中国知网(CNKI)、中国生物医学文献(CBM)、中国万方(Wan Fang)和中国维普(VIP)等数据库,收集RFA与CBA治疗PAF相关随机对照试验(RCT)研究文献。检索时限均自建库至2015年12月。资料提取与质量评价由2名评价员各自独立完成。Rev Man 5.2软件进行Meta分析。结果共纳入6篇RCT研究文献(636例患者)。Meta分析结果显示,与传统RFA相比,CBA增加了术后膈神经麻痹发生率(RR9.26,95%CI2.17~39.63,P=0.003),但手术时间(MD10.07,95%CI-9.10~30.52,P=0.29)、X线透视时间(MD-0.18,95%CI-8.14~7.77,P=0.96)、随访12个月成功率(RR0.91,95%CI0.72~1.14,P=0.40)和房性心动过速(房速)、心房扑动(房扑)、房室折返性心动过速发生率(RR0.47,95%CI0.11~2.02,P=0.31)差异均无统计学意义。结论与传统RFA相比,CBA治疗PAF在手术时间、X线透视时间、随访12个月成功率及房速、房扑、房室折返性心动过速发生率方面无明显差异,但能增加膈神经麻痹发生率。
[Abstract]:Objective to evaluate the clinical effect of cryopreservation balloon ablation (CBA) versus radiofrequency ablation (RFA) on paroxysmal atrial fibrillation (PAF). Methods the databases of Pub Med,EMbase,Cochrane Library,Web of Knowledge, China (CNKI), Chinese biomedical literature (CBM), China Wanfang (Wan Fang) and China Weipu (VIP) were searched by computer. The literature of RFA and CBA related randomized controlled trial (RCT) was collected. The retrieval time limit was built up to December 2015. Data extraction and quality evaluation were analyzed by Meta by. Rev Man 5.2 software. Results A total of 6 RCT studies were included (). Meta analysis of 636 patients showed that compared with traditional RFA, CBA increased the incidence of postoperative phrenic paralysis (RR9.26,95%CI2.17~39.63,P=0.003). But the operative time (MD10.07,95%CI-9.10~30.52,P=0.29), X line fluoroscopy time (MD-0.18,95%CI-8.14~7.77,P=0.96), 12 months follow-up success rate (RR0.91,95%CI0.72~1.14,) There was no significant difference in the incidence of atrioventricular reentrant tachycardia (RR0.47,95%CI0.11~2.02,P=0.31) and atrial tachycardia (atrial tachycardia), atrial flutter (atrial flutter) and atrioventricular reentrant tachycardia (RR0.47,95%CI0.11~2.02,P=0.31). Conclusion compared with traditional RFA, CBA has no significant difference in operation time, X-ray fluoroscopy time, 12 months follow-up success rate and incidence of atrial tachycardia, atrial flutter and atrioventricular reentrant tachycardia, but can increase the incidence of phrenic nerve palsy.
【作者单位】：兰州大学第一医院心外科;兰州大学第一医院胸外科;
【基金】：甘肃省自然科学基金(1606RJZA129) 甘肃省青年科技基金(1606RJYA282、1606RJYA283)
【分类号】：R541.75

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