VA-ECMO联合IABP对心切术后心源性休克患者临床疗效的Meta分析  

Meta-analysis of the Clinical Efficacy of VA-ECMO Combined with IABP in Patients with Cardiogenic Shock after Cardiotomy

作　　者：刘振江 邵铭心 曲爱君[1] LIU Zhenjiang;SHAO Mingxin;QU Aijun(Department of Emergency Medicine,Liaocheng People's Hospital,Liaocheng,Shandong Province,252000 China;Department of Oncology,Liaocheng People's Hospital,Liaocheng,Shandong Province,252000 China)

机构地区：[1]聊城市人民医院急诊科,山东聊城252000 [2]聊城市人民医院肿瘤科,山东聊城252000

出　　处：《中外医疗》2024年第14期30-33,38,共5页China & Foreign Medical Treatment

摘　　要：目的 通过Meta分析方法评价静脉-动脉体外膜肺氧合(Venoarterial Extracorporeal Membrane Oxygenation,VA-ECMO)联合主动脉球囊反搏(Intra-aortic Balloon Pump,IABP)对心切术后心源性休克患者的临床疗效。方法 选择中国知网、维普数据库、万方数据库、PubMed、Cochrane Library等权威数据库,检索关于VA-ECMO联合IABP对心切术后心源性休克患者的中英文文献,时间范围为建库至2024年3月1日,按制订的纳入标准与排除标准筛选文献。对纳入的文献进行质量评价,应用RevMan 5.4对文献进行Meta分析;采用漏斗图分析发表偏倚。结果最终纳入14篇文献,共计2868例患者。Meta结果显示,VA-ECMO联合IABP组可提高VA-ECMO成功脱机率(OR=1.90,95%CI:1.45~2.49,P<0.001),降低心切术后心源性休克患者的院内死亡率(OR=0.83,95%CI:0.69~0.99,P=0.04)。结论 VA-ECMO联合IABP有助于提高心切术后心源性休克患者的VA-ECMO成功脱机率,同时降低院内死亡率。Objective To evaluate the clinical efficacy of venoarterial extracorporeal membrane oxygenation(VA-ECMO)combined with intra-aortic balloon pump(IABP)in patients with cardiogenic shock after cardiotomy by Meta-analysis.Methods Authoritative databases such as China National Knowledge Infrastructure,VIP,Wanfang,PubMed,and Cochrane Library were selected to search the Chinese and English literature on VA-ECMO combined with IABP in patients with cardiogenic shock after cardiotomy,and the time frame was from the establishment of the library to March 1,2024,and the literature was screened according to the established inclusion and exclusion criteria.The qual-ity of the included literature was evaluated,and RevMan 5.4 was applied to perform meta-analysis of the literature,and funnel plots were used to analyze publication bias.Results 14 literatures with a total of 2868 patients were finally included,and the meta-analysis results showed that the VA-ECMO combined with IABP group could increase the rate of successful off-loading of VA-ECMO(OR=1.90,95%CI:1.45-2.49,P<0.001),and reduce the in-hospital mor-tality rate of patients with cardiogenic shock after cardiac resection(OR=0.83,95%CI:0.69-0.99,P=0.04).Conclu-sion VA-ECMO combined with IABP can help to increase the successful deconditioning rate of VA-ECMO in pa-tients with cardiogenic shock after cardiotomy,and also reduce the in-hospital mortality.

关 键 词：体外膜肺氧合 主动脉内球囊反搏 成功脱机 院内死亡 

分 类 号：R541.64[医药卫生—心血管疾病]