腔内治疗急性与非急性StanfordB型夹层国内文献的Meta分析

The endovascular therapy on acute and non-acute Stanford B aortic dissection in China： A metaanalysis

目的系统评价急性与非急性StanfordB型主动脉夹层患者行腔内修复术的技术成功率及术后30d不良事件发生情况。方法全面检索于2009-2014年期间在万方医学网、中国知网上发表的有关急性与非急性StanfordB型夹层腔内治疗效果比较的文献。根据纳入排除标准筛选文献，并提取资料进行Meta分析。结果纳入5篇，共468例患者（急性组243例，非急性组225例）。急性组与非急性组在术后30d总并发症发生率（OR=3．10，95％CI=[1．74，5．53]，P=0．0001）；30d内漏发生率（OR=2．07，95％CI=[1．11，3．88]，P=0．02）均有统计学差异；而2组之间手术成功率（P=0．3）、30d死亡率（P=0．27）及30d主动脉相关死亡率（P=0．26）无统计学差异。结论根据Meta分析数据表明急性StanfordB型主动脉夹层患者在术后30d内发生总并发症率、内漏率要高于非急性期患者：而2组的手术成功率、30d死亡率及主动脉相关死亡率无统计学差异。

Objective To evaluate the technical success, adverse events in 30 days after endovascular repair for acute and non-acute Stanford B aortic dissection. Methods A search was performed to identify all Chinese literatures that compare the effect of TEVAR on acute and non-acute Stanford B dissection in WanFang and Chinese National Knowledge Infrastructure （ CNKI ） from 2009 to 2014. Literatures were extracted arid）（2 test conducted by SPSS 17.0 software, REVMAN 5.3 software was used to conduct meta-analysis and bias analysis by STATA software. Results 5 studies including 468 patients （ acute group 243, non-acute group 225 ） were extracted. Acute Stanford B dissection have higher rate both in total complications（ OR = 3.10,95% CI = [ 1.74, 5.531, P = 0. 000 1 ） and endoleaks （ OR = 2. 07,95% CI=[ 1.11,3.88 ] ,P=0. 02 ） within 30 days than non-acute group, the technique success rate （ P = 0. 3 ） , the mortality rate within 30 days （ P = 0. 27 ） as well as aortic related mortality rate （ P = 0. 26） show no significant difference. Conclusion Acute Stanford B dissection have higher rate of total postoperative complications, endoleaks within 30 days than non-acute group, with similar surgical success rate, 30 days mortality rate and aorta related mortality rate.