中国组织工程研究Issue(5)：920-930,11.DOI:10.3969/j.issn.2095-4344.2013.05.024
非体外循环冠状动脉旁路移植治疗高危冠心病的评价*★
Off-pump coronary artery bypass grafting treats high-risk coronary heart disease
摘要
Abstract
BACKGROUND: Off-pump coronary artery bypass grafting and on-pump coronary artery bypass grafting are the two surgical methods for the treatment of coronary atherosclerotic heart disease, but there is no systematic review on the comparison of these two methods in the treatment of high-risk coronary heart disease. OBJECTIVE: To assess the effect and safety of off-pump versus on-pump coronary artery bypass grafting in perioperative period of high-risk coronary heart disease through Meta analysis. METHODS: Relevant clinical trials published in English and Chinese from January 1993 to June 2012 were searched in PubMed database, EMbase database, China National Knowledge Infrastructure database, China Biomedicine Literature database, VIP database, Wanfang database and Cochrane Library (Issue 8, 2012). Manual searches of bibliographies were also performed. Al the clinical trials were selected and analyzed according to the inclusion and exclusion criteria. Two reviewers independently selected eligible trials, performed quality assessment, and cross-checked each other. Final y, the abstracted relevant data was processed and analyzed with software RevMan 5.1. RESULTS AND CONCLUSION: A total of 16 studies, including two randomized control ed trials and 14 retrospective studies were identified. A total of 6 441 high-risk patients, involving 2 948 in the off-pump coronary artery bypass grafting group and 3 493 in the on-pump coronary artery bypass grafting group were included. The results of Meta-analyses showed the differences of stroke, the intra-aortic bal oon counterpulsation using, recurrent myocardial infarction, respiratory dysfunction and mortality incidence in the perioperative period, the ventilation time, the time in intensive care unit, hospitalization time, postoperative drainage and blood transfusion were significant between off-pump coronary artery bypass grafting and on-pump coronary artery bypass grafting patients. While there were no statistical differences in atrial fibril ation, acute renal injury, wound infection and reoperation rate. Compared with on-pump coronary artery bypass grafting in the perioperative period, using off-pump coronary artery bypass grafting for high-risk patients is safe and effective with the advantages of less trauma, lower operative mortality, rapider postoperative recovery and fewer complications, but because of the limited number of included studies and most is the non-randomized control ed trials, off-pump coronary artery bypass grafting cannot replace on-pump coronary artery bypass grafting. However, the results and long-term efficacy stil need to be confirmed by higher-quality, more multi-center, large-sample and randomized double-blind control ed trials in the future.关键词
器官移植/器官移植循证医学/冠状动脉粥样硬化性心脏病/冠心病/非体外循环冠状动脉旁路移植术/冠状动脉旁路移植术/非体外循环/高危/并发症/房颤/心肌梗死/Meta 分析/其他基金分类
医药卫生引用本文复制引用
王石雄,李宁荫,赵启明,高秉仁..非体外循环冠状动脉旁路移植治疗高危冠心病的评价*★[J].中国组织工程研究,2013,(5):920-930,11.基金项目
中央高校基本科研业务费专项资金(lzujbky-2012-197)。Supported by：Special Fund of Fundamental Research of Central Universities (lzujbky-2012-197)* （lzujbky-2012-197）
