本文選題：經(jīng)導(dǎo)管主動(dòng)脈瓣植入術(shù) + 主動(dòng)脈瓣狹窄　； 參考：《臨床心血管病雜志》2017年06期

【摘要】：目的:應(yīng)用Meta分析的方法來(lái)評(píng)價(jià)經(jīng)導(dǎo)管主動(dòng)脈瓣膜植入術(shù)(TAVI)治療二葉式主動(dòng)脈瓣(BAV)重度狹窄的有效性及安全性。方法:通過(guò)計(jì)算機(jī)檢索建庫(kù)至2016年8月PubMed、The Cochrance Library、Embase、中國(guó)知網(wǎng)和萬(wàn)方數(shù)據(jù)庫(kù)中發(fā)表的有關(guān)TAVI治療BAV重度狹窄的療效與安全性的前瞻性隊(duì)列研究。同時(shí),手工檢索納入文獻(xiàn)的參考文獻(xiàn),查找相關(guān)研究。篩選文獻(xiàn)、提取資料和評(píng)估納入研究的質(zhì)量后,采用STATA12軟件進(jìn)行薈萃分析。結(jié)果:納入5項(xiàng)前瞻性隊(duì)列研究,共2244例患者。NOS評(píng)分最高為8分,最低為7分,說(shuō)明納入文獻(xiàn)質(zhì)量較好。薈萃分析顯示:所繪制的漏斗圖顯示散點(diǎn)均勻分布于中線(xiàn)兩側(cè),Begg及Egger檢驗(yàn)顯示P值均0.05,提示各項(xiàng)研究無(wú)明顯發(fā)表偏倚。與非BVA狹窄組相比較,BAV狹窄組瓣膜置入成功率(RR1.019,95%CI0.982~1.057,P=0.327)、平均跨瓣壓差(SMD0.004,95%CI0.194~0.186,P=0.969)、30d死亡率(RR1.211,95%CI0.525~2.794,P=0.653)、30d復(fù)合終點(diǎn)事件發(fā)生率(RR1.096,95%CI0.684~1.757,P=0.703)、瓣周漏(≥2級(jí))發(fā)生率(RR1.365,95%CI 0.959~1.943,P=0.084)、起搏器植入率(RR0.836,95%CI0.517~1.352,P=0.465)、嚴(yán)重血管并發(fā)癥發(fā)生率(RR1.085,95%CI 0.401~2.936,P=0.872)及致命性出血發(fā)生率(RR0.632,95%CI0.296~1.348,P=0.235)差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:對(duì)于不適合進(jìn)行外科手術(shù)的BAV重度狹窄患者,TAVI是可行、安全和有效的。
[Abstract]:Objective: to evaluate the efficacy and safety of transcatheter aortic valve implantation (TAVI) in the treatment of severe two-lobe aortic valve stenosis by Meta analysis. Methods: a prospective cohort study on the efficacy and safety of TAVI in the treatment of severe BAV stenosis, published in the Cochrance Library Embase, China Zhiwang and Wanfang databases, was searched by computer until Aug. 2016. At the same time, manual retrieval into the literature references, to find relevant research. After screening the literature, extracting the data and evaluating the quality of the research, the meta-analysis was carried out with STATA12 software. Results: in 5 prospective cohort studies, 2244 patients had the highest score of 8 and the lowest of 7, indicating that the quality of the literature included was good. The meta-analysis showed that the scattered points were evenly distributed on both sides of the midline by the funnel diagram and the Egger test showed P value of 0.05, indicating that there was no obvious publication bias in all studies. 涓庨潪BVA鐙獎(jiǎng)緇勭浉姣旇緝,BAV鐙獎(jiǎng)緇勭摚鑶滅疆鍏ユ垚鍔熺巼(RR1.019,95%CI0.982~1.057,P=0.327),騫沖潎璺ㄧ摚鍘嬪樊(SMD0.004,95%CI0.194~0.186,P=0.969),30d姝諱骸鐜，

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