症状性颈动脉狭窄CEA治疗时机的Meta分析

Choice of Surgical Timing of CEA for Symptomatic Carotid Stenosis:a Meta Analysis

评估症状性颈动脉狭窄(SCAS)患者颈动脉内膜剥脱术(CEA)手术时机选择及伴发症状对预后的影响。通过相关检索策略查找探讨CEA手术时机选择对于患者预后影响的随机对照试验。所有数据均采用Revman5.0分析软件进行Meta分析。纳入22篇文献,总计9 037名患者。Meta分析结果显示:SCAS患者4w、2w、1w前后行CEA术后卒中再发率或死亡率组间无统计学差异。合并脑卒中的患者4w、2w前后及合并短暂性脑缺血发作(TIA)或心肌梗死(MI)的患者4w前后行CEA术后卒中再发率或死亡率无统计学差异。症状稳定的SCAS患者应尽早行CEA术,伴发症状脑卒中、TIA和MI不影响手术预后。

To evaluate the effects of the surgical timing of CEA and accompanied symptoms on prognosis of symptomatic carotid stenosis. The published randomized controlled trials （RCTs） about the effects of the surgical timing of CEA and accompanied symptoms on prognosis of symptomatic carotid stenosis were searched, extracted and evaluated by the methodological quality of included studies and then the meta analysis was performed. 22 studies involving 9 037 patients were ineluded. The results of meta analysis showed that there was no statistical difference in postoperative recurrence rate and mortality rate of cerebral stroke in patients who underwent CEA within or beyond 4w, within or beyond 2w, within or beyond lw of the last insult, and no statistical difference in patients accompanied cerebral stroke who underwent CEA within or beyond 4w, within or beyond 2w of the last insult, and no statistical difference in patients accompanied TIA or MI who ufiderwent CEA within or beyond 4w of the last insult. CEA should be done as soon as possible for symptomatic patients of carotid stenosis with stable symptoms. There was no obvious effect of accompanied stroke, TIA and MI on prognosis of symptomatic patients underwent CEA.