临床误诊误治
臨床誤診誤治
림상오진오치
Clinical Misdiagnosis & Mistherapy
2015年
11期
84-90
,共7页
目的：比较第1代与第2代冷冻球囊冷冻消融治疗心房颤动（房颤)的安全性及有效性。方法检索建库至2015年2月27日Pubmed、CBM、CENTRAL、the ISI Web of Knowledge Data-bases、CNKI、EMbase、VIP和万方数据库所有与第1代和第2代冷冻球囊冷冻消融治疗房颤相关的病例对照研究,同时检索相关文献参考文献,依据纳入排除标准等对文献进行筛选,提取相关资料,进行文献质量评价,采用Rev Man 5．1统计软件进行meta分析。结果最终纳入合格文献10篇1441例。 meta分析结果显示第2代组手术时间[SMD =1．27,95%CI（0．97,1．57),P <0．00001]、术中消融时间[SMD=0．67,95%CI（0．50,0．84),P<0．00001]、X线暴露时间[SMD=1．25,95%CI（1．12,1．39),P<0．00001]短于第1代组,冷冻消融次数/肺静脉[SMD=0．75,95%CI（0．28,1．22),P=0．002]少于第1代组,即刻肺静脉隔离（pulmonary vein isolation, PVI)成功率[OR=0．47,95%CI（0．30,0．74),P=0．001]高于第1代组,术中与术后膈神经麻痹（phrenic nerve paralysis, PNP)发生率[OR=0．44,95%CI（0．24,0．82),P=0．009]高于第1代组,差异均具有统计学意义。结论第2代冷冻球囊冷冻消融治疗房颤不仅能够缩短手术时间、消融时间、X线暴露时间,还能减少冷冻消融次数,提高PVI成功率,但其PNP发生率明显高于第1代,需引起重视。
目的：比較第1代與第2代冷凍毬囊冷凍消融治療心房顫動（房顫)的安全性及有效性。方法檢索建庫至2015年2月27日Pubmed、CBM、CENTRAL、the ISI Web of Knowledge Data-bases、CNKI、EMbase、VIP和萬方數據庫所有與第1代和第2代冷凍毬囊冷凍消融治療房顫相關的病例對照研究,同時檢索相關文獻參攷文獻,依據納入排除標準等對文獻進行篩選,提取相關資料,進行文獻質量評價,採用Rev Man 5．1統計軟件進行meta分析。結果最終納入閤格文獻10篇1441例。 meta分析結果顯示第2代組手術時間[SMD =1．27,95%CI（0．97,1．57),P <0．00001]、術中消融時間[SMD=0．67,95%CI（0．50,0．84),P<0．00001]、X線暴露時間[SMD=1．25,95%CI（1．12,1．39),P<0．00001]短于第1代組,冷凍消融次數/肺靜脈[SMD=0．75,95%CI（0．28,1．22),P=0．002]少于第1代組,即刻肺靜脈隔離（pulmonary vein isolation, PVI)成功率[OR=0．47,95%CI（0．30,0．74),P=0．001]高于第1代組,術中與術後膈神經痳痺（phrenic nerve paralysis, PNP)髮生率[OR=0．44,95%CI（0．24,0．82),P=0．009]高于第1代組,差異均具有統計學意義。結論第2代冷凍毬囊冷凍消融治療房顫不僅能夠縮短手術時間、消融時間、X線暴露時間,還能減少冷凍消融次數,提高PVI成功率,但其PNP髮生率明顯高于第1代,需引起重視。
목적：비교제1대여제2대냉동구낭냉동소융치료심방전동（방전)적안전성급유효성。방법검색건고지2015년2월27일Pubmed、CBM、CENTRAL、the ISI Web of Knowledge Data-bases、CNKI、EMbase、VIP화만방수거고소유여제1대화제2대냉동구낭냉동소융치료방전상관적병례대조연구,동시검색상관문헌삼고문헌,의거납입배제표준등대문헌진행사선,제취상관자료,진행문헌질량평개,채용Rev Man 5．1통계연건진행meta분석。결과최종납입합격문헌10편1441례。 meta분석결과현시제2대조수술시간[SMD =1．27,95%CI（0．97,1．57),P <0．00001]、술중소융시간[SMD=0．67,95%CI（0．50,0．84),P<0．00001]、X선폭로시간[SMD=1．25,95%CI（1．12,1．39),P<0．00001]단우제1대조,냉동소융차수/폐정맥[SMD=0．75,95%CI（0．28,1．22),P=0．002]소우제1대조,즉각폐정맥격리（pulmonary vein isolation, PVI)성공솔[OR=0．47,95%CI（0．30,0．74),P=0．001]고우제1대조,술중여술후격신경마비（phrenic nerve paralysis, PNP)발생솔[OR=0．44,95%CI（0．24,0．82),P=0．009]고우제1대조,차이균구유통계학의의。결론제2대냉동구낭냉동소융치료방전불부능구축단수술시간、소융시간、X선폭로시간,환능감소냉동소융차수,제고PVI성공솔,단기PNP발생솔명현고우제1대,수인기중시。
Objective To compare the efficacy and safety of the first generation (G1) cryoballon and second genera-tion (G2) cryoablation in treatment of atrial fibrillation (AF). Methods Databases such as Pubmed, CBM, CENTRAL, the ISI Web of Knowledge Data-bases, CNKI, Embase, VIP and Wanfang were searched from their establishment to February 27 2015 for collecting the case-control studies about G1 cryoballon Versus G2 cryoballon for the treatment of AF and the refer-ences of those case-control studies were also included. The literature was screened according to inclusive criteria, data were extracted and the quality of included studies was assessed, and then meta-analysis was performed with Rev Man 5. 1 software. Results 10 studies involving 1441 patients were included. The meta-analysis showed that: compared with G1 group, G2 group took shorter operation time [SMD=1. 27,95%CI (0. 97,1. 57), P<0. 00001], shorter ablation time[SMD=0. 67, 95%CI (0. 50,0. 84), P<0. 00001] and fluoroscopy time [SMD=1. 25,95%CI (1. 12,1. 39), P<0. 00001]. G2 group needed less total number of applications [SMD=0. 75,95% CI (0. 28,1. 22), P=0. 002]. The success rate of immediate PVI in G2 group was higher than that in G1 group [OR=0. 47,95%CI (0. 30,0. 74), P=0. 001]. The rate of PNP was sig-nificantly higher in G2 group [OR=0. 44,95%CI (0. 24,0. 82), P=0. 009]. Conclusion Compared with G1, using G2 ablation in treating AF not only takes shorter time of surgery, cryoablation, less X-ray exposure and shorter ablation time, but also increases PVI success rate. But we should also notice that the incidence of PNP is significantly higher than that of the first generation cryoballon.
