AngioJet机械血栓清除术与导管接触性溶栓治疗急性下肢深静脉血栓近中期疗效比较的meta分析  

Meta-analysis of the early and mid-term efficacy of AngioJet mechanical thrombectomy and catheter-directed thrombolysis in the treatment of acute lower extremity deep venous thrombosis

作　　者：谭强[1] 陈航 陈镜全 郑国学 郑江华[1] TAN Qiang;CHEN Hang;CHEN Jingquan;ZHENG Guoxue;ZHENG Jianghua(Department of Vascular Surgery,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,P.R.China)

机构地区：[1]川北医学院附属医院血管外科,四川南充637000

出　　处：《中国普外基础与临床杂志》2021年第5期610-618,共9页Chinese Journal of Bases and Clinics In General Surgery

基　　金：川北医学院博士科研启动基金(项目编号:CBY17-QD01)。

摘　　要：目的比较AngioJet机械血栓清除术与导管接触性溶栓(catheter-directed thrombolysis,CDT)治疗急性下肢深静脉血栓(LEDVT)的疗效。方法按照Cochrane协作网的检索策略,收集截至2020年3月25日中国知网、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science等数据库中的国内外相关文献,使用Review Manager 5.3软件对结局指标进行meta分析。结果纳入的20篇文献均为观察性研究,共1566例患者,其中AngioJet组799例,CDT组767例。meta分析结果显示:与CDT组比较,AngioJet组的术后早期深静脉通畅率更高[MD=11.34,95%CI(6.16,16.51),P<0.0001],Villalta评分[MD=-1.90,95%CI(-2.71,-1.10),P<0.00001]、PTS发生率[OR=0.42,95%CI(0.23,0.77),P=0.005]、Ⅰ级血栓清除率[OR=0.40,95%CI(0.24,0.67),P=0.0005]、相关出血并发症发生率[OR=0.32,95%CI(0.21,0.49),P<0.00001]和住院时间[MD=-2.96,95%CI(-3.69,-2.22),P<0.00001]均较低(短)。结论在近期疗效方面,AngioJet机械血栓清除术后的早期深静脉通畅率较CDT更高、溶栓效果更好、住院时间更短且出血风险更低;在中期疗效方面,AngioJet机械血栓清除术能降低PTS的发生率,同时,其发生PTS的严重程度更低。Objective To systematically evaluated the efficacy of AngioJet mechanical thrombectomy and catheterdirected thrombolysis(CDT)in the treatment of acute lower extremity deep venous thrombosis(LEDVT).Methods According to the retrieval strategy of Cochrane collaboration network,the relevant literatures in CNKI,Wang Fang,VIP,CBM,PubMed,Embase,Cochrane Library,Web of Science at home and abroad up to March 25,2020 were collected,and the meta analysis was performed by using Review Manager 5.3 software.Results A total of 20 observational studies were included in the meta analysis.The total number of patients was 1566,which 799 cases in the AngioJet group and767 cases in the CDT group.The results showed that the AngioJet group had a higher patency rate of deep vein[MD=11.34,95%CI(6.16,16.51),P<0.0001],lower or shorter Villalta score[MD=-1.90,95%CI(-2.71,-1.10),P<0.00001],incidence of post-thrombotic syndrome[PTS,OR=0.42,95%CI(0.23,0.77),P=0.005],rate of clot reduction gradeⅠevents[OR=0.40,95%CI(0.24,0.67),P=0.0005],incidence of bleeding complication[OR=0.32,95%CI(0.21,0.49),P<0.00001],and hospital stay[MD=-2.96,95%CI(-3.69,-2.22),P<0.00001].Conclusions In the early efficacy,AngioJet mechanical thrombectomy has better patency rate of deep vein and thrombolysis,shorter hospital stay,and lower risk of bleeding than CDT.In the mid-term effect,AngioJet mechanical thrombectomy could reduce the incidence and the severity of PTS.

关 键 词：急性下肢深静脉血栓 AngioJet机械血栓清除术 导管接触性溶栓 META分析 

分 类 号：R654.4[医药卫生—外科学]