介入封堵术和外科手术治疗中国大陆人群动脉导管未闭的Meta分析  

Interventional occlusion and surgery for patent ductus arteriosus patients in Chinese mainland:Meta-analysis

作　　者：周天津 罗亚玲[1] 周雪晴[1] 万素馨[1] 

机构地区：[1]重庆医科大学医学信息学院,重庆400016

出　　处：《中国介入影像与治疗学》2016年第3期129-133,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：2015年国家社会科学基金项目(15BGL191)

摘　　要：目的比较介入封堵术和外科手术治疗中国大陆人群动脉导管未闭的价值。方法检索中国生物医学文献、PubMed等数据库,收集公开发表的关于介入封堵术和外科手术治疗动脉导管未闭的文献资料。采用RevMan 5.3软件进行统计分析。结果共纳入12篇文献,采用介入封堵术治疗患者782例,外科手术980例。Meta分析显示介入封堵术成功率低于外科手术(RR=0.98,95%CI 0.97~1.00,P=0.03);介入封堵术并发症发生率低于外科手术(RR=0.32,95%CI 0.11~0.95,P=0.04);介入封堵术即时残余分流率高于外科手术(RR=4.26,95%CI 2.21~8.21,P<0.000 01);介入封堵术输血率低于外科手术(RR=0.07,95%CI 0.02~0.21,P<0.000 01);介入封堵术操作时间短于外科手术(SMD=-1.21,95%CI-1.72^-0.70,P<0.000 01);介入封堵术住院时间短于外科手术(SMD=-2.11,95%CI-3.52^-0.70,P=0.000 3);介入封堵术治疗费用高于外科手术(SMD=9.08,95%CI 5.29~12.86,P<0.000 01)。结论介入封堵术手术并发症发生率和手术输血率低,手术时间和住院时间短;在适应证范围内,介入封堵术可为治疗PDA的首选方法。Objective To compare the value of interventional occlusion and surgery for patent ductus arteriosus patients in Chinese mainland.Methods Literature databases such as CBM,PubMed and other databases were searched for collecting published literatures on interventional occlusion and surgery for the treatment of patent ductus arteriosus,and the collected articles were analyzed by RevMan 5.3software.Results A total of 12 articles including 782 cases treated with interventional occlusion and 980 cases treated with surgery were included.Meta analysis showed interventional occlusion success rate was lower than that of surgery（RR=0.98,95%CI 0.97—1.00,P=0.03）;interventional occlusion complication rate was lower than that of surgery（RR=0.32,95%CI 0.11—0.95,P=0.04）;interventional occlusion instant residual shunt rate was higher than that of surgery（RR=4.26,95%CI 2.21—8.21,P〈0.000 01）;interventional occlusion blood transfusion rate was lower than that of surgery（RR=0.07,95%CI 0.02—0.21,P〈0.000 01）;interventional occlusion operation time was shorter than that of surgery（SMD=-1.21,95%CI-1.72—-0.70,P〈0.000 01）;interventional occlusion hospitalization time was shorter than that of surgery（SMD=-2.11,95%CI-3.52—-0.70,P=0.000 3）;interventional occlusion treatment cost was higher than that of surgery（SMD=9.08,95%CI 5.29—12.86,P〈0.000 01）.Conclusion Compared with surgery,interventional occlusion is lower in operation complication rate and operation blood transfusion rate,shorter in operation time and hospitalization time.Interventional occlusion can be the first choice for the treatment of PDA in the range of indication.

关 键 词：动脉导管未闭 介入封堵术 外科手术 META分析 

分 类 号：R541.1[医药卫生—心血管疾病]