经导管与外科手术治疗继发孔型房间隔缺损的Meta分析Transcatheter versus surgical closure of secundum atrial septal defects: a systematic review and Meta-analysis
王宝珠,孟凡华,马翔,马依彤
摘要(Abstract):
目的系统评价经导管与外科手术治疗继发孔型房间隔缺损的临床研究数据。方法计算机检索Pub Med、EMbase、MEDLINE、Cochrane图书馆、CBM、万方数据库及CNKI,纳入经导管与外科手术治疗继发孔型房间隔缺损的随机对照研究(RCT)和队列研究。由两名评价员按照纳入与排除标准筛选文献,提取资料和评价质量后,采用Cochrane协作网提供的Rev Man5.3统计软件进行Meta分析。结果共纳入28篇队列研究(共计14 741例患者)。导管组全因死亡率、并发症发生率、住院时间均低于外科手术组,差异均有统计学意义(OR 0.36,95%CI 0.21~0.59,P<0.0001;OR 0.37,95%CI 0.25~0.55,P<0.0001;WMD–3.77,95%CI–4.36~–3.18 P<0.00001)。导管组残余分流发生率、再次干预率高于外科手术组,差异均有统计学意义(OR 3.55,95%CI 1.79~7.05,P=0.0003)、(OR 2.19,95%CI 1.31~3.65,P=0.003)。结论两种手术方式都是有效的,与外科手术封堵相比,经导管介入封堵治疗继发孔型房间隔缺损具有低死亡率、低并发症发生率以及低住院时间等优势,而外科手术组在残余分流发生率及再次干预率方面有一定优势。
关键词(KeyWords): 经导管;外科手术;房间隔缺损;Meta分析
基金项目(Foundation):
作者(Author): 王宝珠,孟凡华,马翔,马依彤
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