腋动脉和股动脉插管对主动脉A型夹层深低温停循环患者预后指标影响的meta分析  

The impact of axillary versus femoral arterial cannulation on the clinical outcomes in patients with type A acute aortic dissection: evidence from a meta-analysis

作　　者：张军[1] 胡彬[1] 梁飞[1] 张刚[1] 张海洲[1] 张文龙[1] 王正军[1] 邹承伟[1] 许崇恩[1] 

机构地区：[1]山东大学附属省立医院心脏大血管外科,济南250021

出　　处：《中国体外循环杂志》2016年第3期154-158,共5页Chinese Journal of Extracorporeal Circulation

摘　　要：目的本文比较股动脉插管（FAC）和腋动脉插管（AAC）两种灌注模式临床预后的优劣，期望通过循证医学方法找到一种更为可靠有效的灌注模式。方法通过meta分析方法比较AAC和FAC两种插管灌注模式的临床预后。结果总共纳入11个临床研究，共计有988例患者进入分析对比（AAC=495，FAC=493）。同FAC相比，AAC降低了住院死亡率风险[风险比（RR）：0.35；95％置信区间（CI）：0．23～0．53；P〈0．0001]和永久性神经功能损害（PND）（RR：0．49；95％CI：0．33～0．72；P=0．0003）。结论本meta分析表明，在深低温停循环A型主动脉夹层患者住院死亡率和永久性神经功能损害发生率上，AAC优于FAC插管灌注模式。Objective To optimisecl inical outcomes of repair of type A acute aortic dissection througha meta-analysis for arlerial canulation of the femoral or axillary artery. Methods A meta-analysis on comparative studies reporting operative outcomes using FAC versus AAC was conducted. Results Overall, a total of 11 studies including 988 patients were analysed （FAC = 493, AAC = 495）. AAC was related to reduced risk for in-hospital mortality [ risk ratio （RR） ： 0.35; 95% confidence interval （CI） ： 0.23-0.53; P 〈0.0001 ] and permanent neurological deficit （PND） （ RR ： 0.49; 95% CI ： 0.33- 0.72; P = 0.0003 ） when compared with FAC. Conclusion This meta-analysis showed that AAC is superior to FAC in reducing in-hospital mortality and PND in patients operated for type A acute aortic dissection.

关 键 词：体外循环 深低温停循环 A型主动脉夹层 

分 类 号：R654.3[医药卫生—外科学]