单纯经皮腔内血管成形术与支架置入术治疗中短段股腘动脉硬化闭塞症疗效及安全性Meta分析  

Simple percutaneous transluminal angioplasty versus primary stent placement in treating short-intermediate superficial femoral-popliteal artery occlusive disease about clinical safety and efficacy:A Meta-analysis

作　　者：司小毛[1,2] 查斌山[1] 谢文涛[1] 仇鹏[1] 李俊[1] 杨飞[1] 朱化刚[1] 

机构地区：[1]安徽医科大学第一附属医院血管外科,安徽合肥230032 [2]安徽省南陵县中医院普外科,安徽南陵241300

出　　处：《中国实用外科杂志》2013年第11期974-978,共5页Chinese Journal of Practical Surgery

摘　　要：目的应用Meta分析一期支架置入术（stentimplantation，ST）和单纯经皮腔内血管成形术（percutaneoustransluminalangioplasty，PTA）治疗股胭动脉闭塞性疾病的疗效及安全性。方法选取1993年1月至2013年1月发表的9篇前瞻性随机对照研究（RCT），比较ST和PTA的临床疗效，应用Meta分析评价手术成功率、术后再狭窄率、靶血管再干预率等相关指标。结果共有9篇前瞻性随机对照研究纳入此分析，包括948例病人971条肢体，ST组489条，PTA组482条。ST组手术成功率高于PTA组，差异有统计学意义（OR=7．02，95％CI3．83～12．86，P〈0．001）；术后12个月血管再狭窄率ST组低于VrA组，差异有统计学意义（OR=0．58，95％C10．38～0．89，P=0．01），术后24个月血管再狭窄率比较差异无统计学意义（OR=0．82，95％C10．55～1．24，P=0．35）。两组术后靶血管再干预率、血管并发症发生率比较差异无统计学意义（P〉0．05）。结论对于中短段股胭动脉闭塞性病变（≤15cm），ST近期疗效优于PTA，但是没有充足的证据证明ST组的远期（≥24个月）疗效及安全性优于PTA组。Objective To compare the clinical safety and efficacy of primary stent placement （ST） versus simple percutaneous transluminal angioplasty （FFA） in treating superficial femoral-popliteal artery （SFPA） occlusive disease using Meta-analysis method. Methods Prospective randomized controlled trials （RCT）comparing ST and PTA clinical effects published from January 1993 to January 2013 were retrieved. A Meta-analysis was conducted to estimate the immediate operation success rate, postoperative restenosis rate, target vessel revascularization （TVR）. Results A total of 9 RCT were included in the analysis, including 948 patients and 971 limbs, 489 limbs in ST group and 482 limbs in PTA group. The immediate operation success rate was higher in the ST group and the difference was significant statistically （OR=7.02, 95% CI 3.83-12.86, P〈0.001）. Postoperative 12 months vascular restenosis rates in ST group were less than those in PTA group with significant difference （OR-0.58,95%CI 0.38-0.89, P=0.01 ）. The difference of postoperative 24 months vascular restenosis rates between two groups was not significant statistically （OR=0.82,95%CI 0.55-1.24, P=0.35）. There was no difference statistically in target vessel revascularization and vascular complications between two groups （P〉0.05）. Conclusion For short-intermediate SFPA occlusion lesions （less than 15era）, short-term outcomes of ST is better than the PTA. But there is not enough evidence to prove that long-term outcome （longer than 24 months） of ST group is better than the PTA group.

关 键 词：周围血管疾病 支架置入术 经皮腔内血管成形术 META分析 

分 类 号：R6[医药卫生—外科学]