血管内支架治疗肝静脉型布加综合征临床价值的Meta分析  

The clinical value of endovascular stent in treatment of hepatic vein-type Budd-Chiari syndrome： a Meta analysis

作　　者：马强[1] 余朝文[1] 任佩[3] 孙喆[2] 

机构地区：[1]蚌埠医学院第一附属医院血管外科,安徽省蚌埠市233000 [2]蚌埠医学院第一附属医院影像科 [3]兰州大学第二医学院内分泌科

出　　处：《中华解剖与临床杂志》2016年第1期46-49,共4页Chinese Journal of Anatomy and Clinics

摘　　要：目的荟萃分析血管内支架在治疗肝静脉型布加综合征中的临床价值。方法采用Newcastle—OttawaScale评价方法，通过计算机检索并收集国内外关于肝静脉型布加综合征血管内支架治疗的文献，检索时限为1992年1月—2014年7月，对收集到的资料进行总结，并对血管内支架与单纯性球囊扩张术后再狭窄率、闭塞率进行Meta分析。结果按照检索策略进行系统的检索后，依照纳入标准，最终纳入6篇中文文献，1篇英文文献，共汁534例病例。Meta分析结果显示，埘单纯性球囊扩张与血管内支架置入术后再狭窄、闭塞结果进行合并，异质性检验显示有明显的异质性（X2=15．821，P〈0．05，I2=62％）。采用随机效应模型，结果显示合并的RR值为0．63（95％CI：0．21～1，88，P〉0．05），血管内支架与单纯性球囊扩张在术后近、中期再狭窄、闭塞率差异均无统计学意义（P值均〉0．05）。结论肝静脉型布加综合征采用血管内支架与单纯性球囊扩张术治疗，术后近、中期再狭窄、闭塞率无差异，埘于单纯性球囊扩张效果不明显或需多次扩张的患者可考虑行血管内支架置入治疗。Objective To analyze the clinical significance of endovascular stents in treatment of hepatic vein type Budd-Chiari syndrome. Methods Newcastle-Ottawa Scale assessment method was used by carrying out the computer-based retrieval and collecting the documents about the endovaseular stents in treatment of hepatic vein type Budd-Chiari syndrome at home and abroad, the searching time limit was set from January 1992 to July 2014, all of colleeted data were analyzed and summarized, and the Meta analysis was conducted for the diameter stenosis and blocking rate of postoperative endovascular stents and percutaneous translmninal angioplasty. Results After systematic retrieval based on search strategies, according to inclusion criteria, there were 6 Chinese papers and one English paper included, with a total of 534 patients. The Meta analysis was conducted for the diameter stenosis and blocking rate of postoperative endovascular stents and pereutaneous transluminal anginplasty in those included papers. The results showed that, filer combining the diameter stenosis and blocking rate of postoperative percutaneous transluminal angioplasty and endovaseular stents, the tests for heterogeneity revealed that it had the significant heterogeneity （X2 = 15. 821, P 〈0.05, I2 = 62% ）. After using a random-effect model, the results showed that the merged RR value was 0.63 （95% CI：0. 21 - I. 88, P 〉0.05）, which indicated that the diameter stermsis and blocking rate of postoperative endovascular stents and pereutaneous transluminal angioplasty in short-and medium-term had no significant differences. Conclusions Endovascular stents have advantages of a high success rate, higher safety and minimal invasion with definite efficacy in treatment of hepatic vein type Budd-Chiari syndrome. The diameter stenosis and blocking rate of postoperative endovaseular stents and pereutaneous transluminal angioplasty in short-and medium-term had no significant differences, For patients with unclear therapeutic effects in percutaneous translumi

关 键 词：dd—Chiari综合征 肝静脉阻塞 介入治疗 血管内支架 

分 类 号：R657.3[医药卫生—外科学]