摘要
目的比较经胸封堵术与经皮封堵术治疗室间隔缺损(VSD)的疗效及术后并发症之间的差异,观察其安全性及有效性之间的差异。方法计算机检索PubMed、Web of Science、The Cochrane Library、万方数据库、中国知网,检索时间为建库至2019年12月11日。筛选满足纳入标准的文献,提取数据并评价文献质量,采用RevMan 5.3进行Meta分析。结果共纳入10篇文献,均为队列研究,共2286例VSD患者,经胸封堵组1299例,经皮封堵组987例。经胸封堵组手术成功率高于经皮封堵组,差异有统计学意义(95.8%比92.6%,OR 1.65,95%CI 1.14~2.40,P=0.008);而总并发症发生率(OR 1.78,95%CI 0.81~3.90,P=0.15)和手术时间(MD 1.82,95%CI-25.13~28.76,P=0.89)两组间差异均无统计学意义。经胸封堵组住院时间(MD 0.83,95%CI 0.40~1.26,P=0.0002)及手术费用(MD 0.26,95%CI 0.02~0.50,P=0.03)均高于经皮封堵组,差异均有统计学意义。结论经胸封堵术相较于经皮封堵术手术成功率、住院时间和手术费用均更高,在总并发症发生率与手术时间方面与经皮封堵组差异无统计学意义。
Objective To compare the efficacy,safety,and cost of transthoracic closure and percutaneous closure to treat ventricular septal defect(VSD)using the Meta-analysis method.Methods PubMed,Cochrane Library,Web of Science databases,Wanfang database,and CNKI were searched for studies meeting the criterion through December 11,2019.Quality of the studies was assessed and data of included articles were extracted and analyzed using RevMan 5.3.Results Ten retrospective cohort studies with a total of 2286 patients(TC group=1299,PC group=987)were identified.The procedural success rate of the TC group was higher than the PC group(95.8%vs.92.6%,OR 1.65,95%CI 1.14-2.40,P=0.008).No significant differences were observed between the TC group vs.the PC group in terms of total complications(OR 1.78,95%CI0.81-3.90,P=0.15)or operative time(MD 1.82,95%CI-25.13-28.76,P=0.89).Compared with the PC group,the length of hospital stay was longer(MD 0.83,95%CI 0.40-1.26,P=0.0002)and hospital cost was more(MD 0.26,95%CI 0.02-0.50,P=0.03)of the TC group with statistical significance.Conclusions Transthoracic closure of VSD had a higher procedural success rate without increased risk of total complications but also needed more operative time and costs when compared with percutaneous closure.
作者
王利军
龚成武
刘季春
WANG Li-jun;GONG Cheng-wu;LIU Ji-chun(Department of Cardiac Surgery,the Second Affi liated Hospital of Nanchang University,Nanchang 330006,China)
出处
《中国介入心脏病学杂志》
2021年第10期580-588,共9页
Chinese Journal of Interventional Cardiology
关键词
室间隔缺损
经胸封堵术
经皮封堵术
META分析
Ventricular septal defect
Transthoracic closure
Percutaneous closure
Meta analysis
