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开放手术和腔内技术治疗复杂腹主动脉瘤的网状Meta分析 被引量:1

Open surgical repair versus endovascular aortic repair of complex abdominal aortic aneurysms:a network meta-analysis
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摘要 目的使用网状Meta分析比较开窗技术、烟囱技术和开放手术治疗复杂腹主动脉瘤的疗效。方法计算机检索PubMed、Embase、Cochrane Library、中文期刊全文数据库和万方数据库,检索1999年1月1日至2022年2月15日发表的关于开窗技术、烟囱技术和开放手术治疗择期复杂腹主动脉瘤疗效对比的研究。运用ADDIS 1.16.6和Stata 16.0软件进行网状Meta分析。结果共纳入12篇观察性研究,共计3594例患者。网状Meta分析结果显示三种手术方式在早期再干预率、30 d死亡率、肠缺血、切口并发症、下肢缺血、卒中或脑缺血发作并发症发生率方面差异无统计学意义(均P>0.05);在心肌梗死方面,开窗技术和烟囱技术优于开放手术;对于急性肾损伤,开窗技术优于开放手术和烟囱技术(P<0.05)。结论对于择期复杂腹主动脉瘤患者,开窗技术、烟囱技术和开放手术在早期再干预率和30 d死亡率方面差异均无统计学意义,但开窗技术和烟囱技术可减少早期并发症的发生。 Objective To compare the efficacy of fenestrated endovascular aortic repair(FEVAR),chimney endovascular aortic repair(ChEVAR),and open surgical repair(OSR)of complex abdominal aortic aneurysms(cAAA)by conducting network Meta-analysis.Methods PubMed,Embase,Cochrane Library,CNKI,and Wanfang Database were searched to find studies published between January 1,1999,and February 15,2022,and compare the efficacy of FEVAR,ChEVAR,and OSR of elective cAAA.The network Meta-analysis was performed using ADDIS 1.16.6 software and STATA 16.0.software.Results A total of 12 observational studies were included in this network Meta-analysis with 3594 patients.Among the three treatments,there was no statistically significant difference in early reintervention,30-day mortality,and the incidence of bowel ischemia,wound complications,lower extremity ischemia,and stroke or cerebral ischemia(all P>0.05).OSR had a higher incidence of myocardial infarction(P<0.05);FEVAR had a lower incidence of acute kidney injury(P<0.05).Conclusion For patients with elective cAAA,there is no statistically significant difference between early reintervention and 30-day mortality among FEVAR,ChEVAR and OSR,but FEVAR and ChEVAR could reduce the incidence of early complications.
作者 张坤 郑焕勤 陈忠 Zhang Kun;Zheng Huanqin;Chen Zhong(Department of Vascular Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处 《中华血管外科杂志》 2022年第2期115-121,共7页 Chinese Journal of Vascular Surgery
关键词 腹主动脉瘤 复杂 开放手术 腔内修复术 开窗技术 烟囱技术 治疗 网状Meta分析 Complex abdominal aortic aneurysms Open surgical repair Endovascular aortic repair Fenestrated endovascular aortic repair Chimney endovascular aortic repair Treatment Network meta-analysis
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