心血管外科杂志(电子版)
心血管外科雜誌(電子版)
심혈관외과잡지(전자판)
Journal of Cardiovascular Surgery (Electronic Edition)
2015年
2期
86-92
,共7页
李俊红%阿布都乃比%艾克热木%木拉提
李俊紅%阿佈都迺比%艾剋熱木%木拉提
리준홍%아포도내비%애극열목%목랍제
心脏瓣膜假体植入%外科手术,微创性%Meta 分析%小切口
心髒瓣膜假體植入%外科手術,微創性%Meta 分析%小切口
심장판막가체식입%외과수술,미창성%Meta 분석%소절구
Heart valve prosthesis implantation%Surgical procedures,minimally invasive%Meta-analysis%Minithoracotomy
目的系统评价微创右胸小切口行二尖瓣置换术的有效性和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library(2014第2期)、CBM、CNKI、WanFang Data 和 VIP,收集有关微创右胸小切口行二尖瓣置换术的队列研究,检索时限均为从建库至2014年6月,由两位评价者按照纳入与排除标准独立选择文献、提取资料和方法学质量评价后,采用 RevMan 5.2软件进行 Meta 分析。结果最终纳入7个研究,共计1372例患者,Meta 分析结果显示:与传统组相比,微创组延长了术中体外循环时间[SMD =0.41,95% CI(0.16,0.66),P =0.001]和主动脉阻断时间[SMD =0.49,95% CI(0.13,0.84),P =0.007],但在术后住院时间[SMD =-0.84,95% CI(-1.25,-0.43),P <0.00001]、术后 ICU 住院时间[SMD =-0.54,95% CI(-0.90,-0.17),P =0.004]及术后引流量[SMD =-1.89,95% CI(-3.21,-0.58),P =0.005]显著少于传统组,两组差异均有统计学意义。术后呼吸机使用时间[SMD =-0.64,95% CI(-1.32,0.04),P =0.06]及围术期死亡率[OR =0.56,95% CI(0.18,1.77),P =0.33]方面,两组差异无统计学意义。结论微创右胸小切口二尖瓣置换术创伤小、恢复快、安全有效,值得临床推广应用。受纳入研究质量和数量所限,上述结论仍需开展更多高质量前瞻性的试验设计加以验证。
目的繫統評價微創右胸小切口行二尖瓣置換術的有效性和安全性。方法計算機檢索PubMed、EMbase、The Cochrane Library(2014第2期)、CBM、CNKI、WanFang Data 和 VIP,收集有關微創右胸小切口行二尖瓣置換術的隊列研究,檢索時限均為從建庫至2014年6月,由兩位評價者按照納入與排除標準獨立選擇文獻、提取資料和方法學質量評價後,採用 RevMan 5.2軟件進行 Meta 分析。結果最終納入7箇研究,共計1372例患者,Meta 分析結果顯示:與傳統組相比,微創組延長瞭術中體外循環時間[SMD =0.41,95% CI(0.16,0.66),P =0.001]和主動脈阻斷時間[SMD =0.49,95% CI(0.13,0.84),P =0.007],但在術後住院時間[SMD =-0.84,95% CI(-1.25,-0.43),P <0.00001]、術後 ICU 住院時間[SMD =-0.54,95% CI(-0.90,-0.17),P =0.004]及術後引流量[SMD =-1.89,95% CI(-3.21,-0.58),P =0.005]顯著少于傳統組,兩組差異均有統計學意義。術後呼吸機使用時間[SMD =-0.64,95% CI(-1.32,0.04),P =0.06]及圍術期死亡率[OR =0.56,95% CI(0.18,1.77),P =0.33]方麵,兩組差異無統計學意義。結論微創右胸小切口二尖瓣置換術創傷小、恢複快、安全有效,值得臨床推廣應用。受納入研究質量和數量所限,上述結論仍需開展更多高質量前瞻性的試驗設計加以驗證。
목적계통평개미창우흉소절구행이첨판치환술적유효성화안전성。방법계산궤검색PubMed、EMbase、The Cochrane Library(2014제2기)、CBM、CNKI、WanFang Data 화 VIP,수집유관미창우흉소절구행이첨판치환술적대렬연구,검색시한균위종건고지2014년6월,유량위평개자안조납입여배제표준독립선택문헌、제취자료화방법학질량평개후,채용 RevMan 5.2연건진행 Meta 분석。결과최종납입7개연구,공계1372례환자,Meta 분석결과현시:여전통조상비,미창조연장료술중체외순배시간[SMD =0.41,95% CI(0.16,0.66),P =0.001]화주동맥조단시간[SMD =0.49,95% CI(0.13,0.84),P =0.007],단재술후주원시간[SMD =-0.84,95% CI(-1.25,-0.43),P <0.00001]、술후 ICU 주원시간[SMD =-0.54,95% CI(-0.90,-0.17),P =0.004]급술후인류량[SMD =-1.89,95% CI(-3.21,-0.58),P =0.005]현저소우전통조,량조차이균유통계학의의。술후호흡궤사용시간[SMD =-0.64,95% CI(-1.32,0.04),P =0.06]급위술기사망솔[OR =0.56,95% CI(0.18,1.77),P =0.33]방면,량조차이무통계학의의。결론미창우흉소절구이첨판치환술창상소、회복쾌、안전유효,치득림상추엄응용。수납입연구질량화수량소한,상술결론잉수개전경다고질량전첨성적시험설계가이험증。
Objective To systematically review the efficacy and safety of minimally invasive mitral valve replacement via right minithoracotomy .Methods Databases including PubMed,EMbase,The Cochrane Library (Issue 2,2014),CBM,CNKI,WanFang Data and VIP were searched electronically from their inception to June 2014.Two reviewers identified the literature independently according to inclusion and exclusion criteria .After data extraction and quality assessment of the included studies ,Meta-analysis was performed using RevMan 5.2 software. Results A total of seven studies involving 1372 cases were included.The results of Meta-analysis showed that:compared with traditional group,minimally invasive group prolonged cardiopulmonary bypass time [SMD =0.41, 95% CI(0.16,0.66),P =0.001],and aortic clamping time [SMD =0.49,95% CI(0.13,0.84),P =0.007], but the postoperative hospital stay [SMD =-0.84,95% CI( -1.25, -0.43),P <0.000 01],postoperative ICU stay [SMD =-0.54,95% CI( -0.90, -0.17),P =0.004]and postoperative drainage [SMD =-1.89,95% CI ( -3.21, -0.58),P =0.005] in minimally invasive group were significantly less than that in the traditional group,the difference was statistically significant .There was no statistical significance in postoperative mechanical ventilation time [SMD =-0.64,95% CI( -1.32,0.04),P =0.06]and perioperative mortality[OR =0.56,95%CI(0.18,1.77),P =0.33].Conclusion Minimally invasive mitral valve replacement via right minithoracotomy has the disadvantages of minor trauma ,quicker recovery,safe and effective and is worthy of promotion.Due to the quantity and quality of the included studies ,the above conclusion still needs to be verified by carrying out more high-quality prospective trial designs.