经皮球囊肺动脉瓣成形术与外科手术治疗肺动脉瓣狭窄有效性与安全性的Meta分析  

Efficacy and safety via Meta analysis of percutaneous balloon pulmonic valvuloplasty and surgery in pulmonary stenosis

作　　者：谢靖芸[1,2] 田杰[2] 刘琴[3] 

机构地区：[1]重庆第二师范学院卫生科,400067 [2]重庆医科大学附属儿童医院心脏内科 [3]重庆医科大学公共卫生与管理学院中国循证卫生保健协作网

出　　处：《中华实用儿科临床杂志》2013年第23期1793-1796,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的评估治疗肺动脉瓣狭窄（PS）的经皮球囊肺动脉瓣成形术（PBPV）与传统外科手术的疗效与安全性，为优化临床治疗提供一定的参考。方法检索PubMed、OVID、Medline、中国生物医学文献数据库、中文科技期刊数据库、万方数据知识服务平台与中国知识资源总库，收集所有Ps患者PBPV与外科手术治疗的对照试验病例。采用Revman软件（5．0版）对数据进行Meta分析。结果共纳入文献5篇，547例Ps患者。PBPV组与外科手术组年龄、体质量、术前肺动脉瓣跨瓣压差（PG）值比较差异均无统计学意义。Meta分析结果：2组成功率差异无统计学意义（96．2％比100％，P=0．46）；2组存活率均为100％；PBPV组术后肺动脉瓣返流发生率低于外科手术组（34．9％比70．5％，P=0．001）；PBPV组术后24h内PG值高于外科手术组（P=0．003）；PBPV组的并发症发生率低于外科手术组（6．83％比26．50％，P〈0．00001）。结论PBPV治疗Ps有效性与安全性好，但治疗有选择性，成功率有待进一步提高。对具有适应证的PS患者，可优先选择PBPV治疗。Objective To systematically evaluate the effect of percutaneous balloon pulmonic valvuloplasty （PBPV） and the surgery in pulmonary stenosis（PS） ,so that suitable treatment would be selected partly based on this study. Methods PubMed, OVID, Medline, Chinese Biomedicine database, VIP Database for Chinese Technical Periodi- cals, digital journal of Wanfang Data and China National Knowledge Internet were searched to locate relevant controlled trials. Data extraction and assessment of methodologic quality were performed independently by 2 reviewers. Meta analy- sis was performed by Revman 5.0 software. Results Five papers （ including 547 patients ） were identified. The age, weight and preoperative pressure gradient were similar in 2 groups. The success rate in PBPV group was similar to surgi- cal group （96.2% vs 100% , P = 0.46）. The survival rate in 2 groups were all 100%. The pulmonic regurgitation rate in PBPV group was lower than that in surgical group （34.9% vs 70.5 % ,P = 0.001 ）. The postoperative pressure gradient in PBPV group were higher than that in surgical group（P = 0. 003 ）. Complication rate in PBPV group was lower than that surgical group （6.83 % vs 26.50% ,P 〈 0. 000 01 ）. Conclusions The PBPV is safe and effective, but it is selec- tive and the success rate needs to be increase. If the patient with pulmonary stenosis is suitable, PBPV will be the first choice.

关 键 词：肺动脉瓣狭窄 经皮球囊肺动脉瓣成形术 外科手术 META分析 

分 类 号：R726.5[医药卫生—儿科]