摘要
目的评价左侧对比右侧桡动脉入路行冠状动脉介入术的有效性与安全性。方法计算机检索PubMed、EMBASE、Web of Science、Cochrane图书馆、中国生物医学文献数据库、中文科技期刊全文数据库、数字化期刊数据库和中国期刊全文数据库,时间从1989年至2013年2月。由两名研究人员独立地按照纳入与排除标准以及Cochrane协作网推荐的方法筛选文献、评价质量,并采用RevMan 5.1软件进行Meta分析。结果共纳入13个研究,包括6 605例患者。Meta分析结果显示:右侧桡动脉入路组发生入路更改的可能性是左侧桡动脉入路组的1.37倍[相对危险度1.37,95%可信区间(1.10,1.71),P=0.005],左侧桡动脉入路有利于缩短手术时间[均数差0.73,95%可信区间(0.09,1.36),P=0.02]。两组在外周血管并发症、主要不良心脏事件方面差异无统计学意义(P>0.05)。结论左侧桡动脉入路组与右侧桡动脉入路组相比,具有较低的入路更改率及较短的手术操作时间,处于学习曲线期的术者使用左侧桡动脉入路完成冠状动脉介入术时更有优势。
Objective To assess the efficacy and safety of left （LRA） versus right radial approach （RRA） for coronary diagnostic or interventional procedures. Methods The databases were＇searched including PubMed, EMBASE, Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang. Two reviewers extracted data independently according to the methods of Cochrane Collaboration. Statistical analysis was performed using Review Manager software （RevMan 5.1, Cochrane Collaboration, Oxford, UK）. Results 13 trials with 6 605 patients were included in the meta-analysis. The results showed no significant difference in the risks of peripheral vascular complications and major adverse cardiac events comparing LRA with RRA （P〉0.05）. However, in comparison with LRA, RRA arm was fraught with a significantly higher risk of failure leading to cross-overs to other access [ risk ratio 1.37, 95% confidence interval （1.10,1.71）, P=0.005], and a prolonged procedural time [mean difference 0.73, 95% confidence interval （0.09,1.36）, P=0.02]. Conclusions Compared with RRA, LRA could reduce the risk of other access cross-overs and the procedural time. LRA could be recommended to complete coronary intervention for operators during the learning curve phase.
出处
《循证医学》
CSCD
2013年第6期363-369,共7页
The Journal of Evidence-Based Medicine
关键词
冠状动脉介入术
桡动脉
META分析
percutaneous coronary intervention
radial artery
meta-analysis
