经远端桡动脉与经传统桡动脉入路行冠状动脉介入诊疗RCT研究的Meta分析  

Meta-analysis of RCT Studies on Coronary Intervention Through Distal Radial Artery and Traditional Radial Artery Approach

作　　者：王鹏飞 高丽华 史文册 陈传军[1] 苏工 WANG Peng-fei;GAO Li-hua;SHI Wen-ce;CHEN Chuan-jun;SU Gong(Department of Cardiology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院心脏医学部,北京100049

出　　处：《医学信息》2024年第15期21-26,共6页Journal of Medical Information

基　　金：航天中心医院科研基金项目(编号:YN202202)。

摘　　要：目的应用Meta分析评估冠状动脉介入诊疗中经远端桡动脉入路与经桡动脉入路穿刺成功率、穿刺时间及穿刺并发症发生率。方法使用计算机检索PubMed、EMbase、Cochrane Library、中国生物医学服务系统(Si-nomed)、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普(VIP)等数据库。由3名研究员独立收集数据,2名研究者评估数据内容并使用RevMan5.3软件进行Meta分析。结果共纳入12篇RCT研究,共4886例患者。与经传统桡动脉穿刺入路相比,经远端桡动脉入路穿刺成功率较低(OR=6.73,95%CI:4.58~9.90,P<0.00001,Z=9.69),一次穿刺成功率较低(OR=2.86,95%CI:2.37~3.45,P<0.00001,Z=10.96),穿刺时间更长(OR=0.73,95%CI:0.40~1.06,P<0.0001,Z=4.30),远端桡动脉入路的闭塞率较低(OR=0.25,95%CI:0.18~0.35,P<0.00001,Z=7.98);两组局部血肿(OR=0.88,95%CI:0.64~1.21,P=0.43,Z=0.80)、桡动脉痉挛(OR=1.00,95%CI:0.62~1.61,P=0.99,Z=0.01)比较,差异无统计学意义。结论与传统桡动脉入路相比,经远端桡动脉入路在行冠脉介入诊疗时穿刺成功率较低、穿刺时间较长,局部血肿及桡动脉痉挛发生率无明显变化,但可有效避免桡动脉闭塞。Objective To evaluate the success rate,puncture time and incidence of puncture complications between distal radial artery approach and transradial artery approach in coronary intervention by Meta-analysis.Methods PubMed,EMbase,Cochrane Library,Si-nomed,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP and other databases were searched by computer.Three researchers independently collected data,and two researchers assessed the data content and used RevMan5.3 software for meta-analysis.Results A total of 12 RCT studies involving 4886 patients were included.Compared with the traditional radial artery puncture approach,the success rate of distal radial artery puncture was lower(OR=6.73,95%CI:4.58-9.90,P<0.00001,Z=9.69),the success rate of one-time puncture was lower(OR=2.86,95%CI:2.37-3.45,P<0.00001,Z=10.96),and the puncture time was longer(OR=0.73,95%CI:0.40-1.06,P<0.0001,Z=4.30),the occlusion rate of distal radial artery approach was lower(OR=0.25,95%CI:0.18-0.35,P<0.00001,Z=7.98).There was no significant difference in local hematoma(OR=0.88,95%CI:0.64-1.21,P=0.43,Z=0.80)and radial artery spasm(OR=1.00,95%CI:0.62-1.61,P=0.99,Z=0.01)between the two groups.Conclusion Compared with the traditional radial artery approach,the distal radial artery approach has a lower puncture success rate and a longer puncture time during coronary intervention.There is no significant change in the incidence of local hematoma and radial artery spasm,but it can effectively avoid radial artery occlusion.

关 键 词：桡动脉 远端桡动脉 冠状动脉介入诊疗 

分 类 号：R541.4[医药卫生—心血管疾病]