朱政,陈剑飞,卢美华

• 1:重庆市巴南区人民医院心血管内科
• 2:重庆市巴南区人民医院全科医学

摘要(Abstract)：

目的 比较心外膜联合心内膜导管消融（杂交）与单纯心内膜导管消融（导管治疗持续性心房颤动（房颤）的有效性和安全性。方法 利用PubMed、Embase和The Cochrane Library数据库进行系统性检索，检索时间为建库至2022年3月31日。主要临床终点为远期消融成功率和手术并发症。次要临床终点包括术后电复律、二次消融、手术时间和X线透视时间。结果 纳入9篇研究（2篇随机对照研究和7篇观察性研究）共834例持续性房颤患者。其中380例分布在杂交手术组，454例分布在导管组，平均随访19.1个月。Meta分析显示，与导管消融相比，尽管杂交手术有改善房颤远期成功率的趋势（OR 1.92,95%CI 0.89～4.12,P=0.090），但是显著增加手术并发症发生风险（OR 4.18,95%CI 2.48～7.03,P<0.001），包括严重并发症发生风险（OR 2.90,95%CI1.34～6.31,P=0.007）和死亡风险（OR6.96,95%CI1.43～33.87,P=0.020）。另外，杂交手术减少电复律及二次消融风险，没有明显延长手术时间和X线透视时间。结论 尽管杂交手术提高持续性房颤消融的成功率，但会显著增加手术并发症发生风险，包括严重并发症及死亡。

关键词(KeyWords)： 心房颤动;杂交手术;导管消融;Meta分析

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 朱政,陈剑飞,卢美华

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