CAJ | 학술논문

目的：运用循证医学方法探讨二尖瓣手术（MVS）联合冠状动脉搭桥术（CABG）治疗中重度缺血性二尖瓣反流（ IMR）的疗效。方法计算机检索OVID、MEDLINE、EMBASE、Web of Science、Cochrane Liborary等数据库中有关CABG及CABG＋MVS治疗中重度IMR患者的临床研究，采用Stata 12．0软件进行Meta分析。结果共纳入9个非随机试验和1个随机对照试验，其中CABG组1549例， CABG＋MVS组1002例。Meta分析结果显示，MVS＋CABG与CABG组远期死亡率、术后远期纽约心功能分级比较，差异无统计学意义（P＞0．05）；MVS＋CABG在改善远期二尖瓣反流分级方面优于CABG（P＜0．05）。结论在治疗中重度IMR方面是否有必要联合CABG与MVS仍需要更多的临床研究证实。
목적：운용순증의학방법탐토이첨판수술（MVS）연합관상동맥탑교술（CABG）치료중중도결혈성이첨판반류（ IMR）적료효。방법계산궤검색OVID、MEDLINE、EMBASE、Web of Science、Cochrane Liborary등수거고중유관CABG급CABG＋MVS치료중중도IMR환자적림상연구，채용Stata 12．0연건진행Meta분석。결과공납입9개비수궤시험화1개수궤대조시험，기중CABG조1549례， CABG＋MVS조1002례。Meta분석결과현시，MVS＋CABG여CABG조원기사망솔、술후원기뉴약심공능분급비교，차이무통계학의의（P＞0．05）；MVS＋CABG재개선원기이첨판반류분급방면우우CABG（P＜0．05）。결론재치료중중도IMR방면시부유필요연합CABG여MVS잉수요경다적림상연구증실。
Objective To investigate the effect of mitral valve surgery (MVS) combined with coronary artery bypass graft(CABG) on moderate,severe ischemic mitral regurgitation (IMR) with the method of evidence-based medicine. Methods The databases including OVID,MEDLINE,EMBASE,Web of Science,Cochrane Library were retrieved for the relevant clinical trials on CABG and CABG plus MVS for the treatment of moderate ,severe IMR patients .Stata 12.0 software was applied to a Meta-analysis.Results Nine non-randomized trials and 1 randomized controlled trial were included ,1 549 cases in the CABG group ,1002 cases in the CABG plus MVS group .The results of Meta-analysis were as follows .There were no significant differences in the long-term mortality,long-term postoperative NYHA heart function classification between CABG plus MVS group and CABG group (P>0.05).CABG plus MVS was superior to CABG in terms of the long-term mitral regurgitation grade(P<0.05).Conclusion More clinical studies are needed to demonstrate the necessity of applying CABG combined with MVS to the treatment of moderate to severe IMR .