经远端桡动脉路径行冠状动脉介入诊疗的Meta分析
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(1.河北医科大学第二医院心血管内五科,河北省石家庄市 050000;2.河北医科大学研究生学院,河北省石家庄市 050017)

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牛绍乾,硕士研究生,主要研究方向为心血管疾病研究,E-mail为435836814@qq.com。通信作者傅向华,博士,主任医师,博士研究生导师,主要研究方向为冠心病、介入心脏病学,E-mail为fuxh999@163.com。

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Interventional diagnosis and treatment of coronary artery through the distal radial artery:a Meta-analysis
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1.The 5th Department of Cardiovascular, the Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China;2.Graduate School of Hebei Medical University, Shijiazhuang, Hebei 050017, China)

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    摘要:

    目的 通过Meta分析评价经远端桡动脉路径行冠状动脉介入诊疗的安全性与有效性。方法 计算机检索Pubmed、Embase、Web of Science、Cochrane Library、中国生物医学服务系统(Sinomed)、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普(VIP)等数据库,检索时限为2017年1月1日—2020年5月31日。由两位研究人员根据Cochrance偏倚风险评估工具进行分析评估后进行Meta分析。结果 按预定检索策略在各数据库及其他途径共得到1 617篇文献,排除研究设计不合理,无对照组或对照组为其他部位血管(如股动脉等),排除动物实验、综述、系统评价、病例报告等最终筛选出10篇文献,共计7 497例患者进行Meta分析。Meta分析结果显示,与经典桡动脉路径相比,经远端桡动脉路径行冠状动脉介入诊疗穿刺成功率、桡动脉痉挛发生情况、局部血肿发生情况差异无统计学意义(P>0.05),桡动脉闭塞情况较低[OR=0.4,5%CI(0.8,0.69),Z=3.56,P<0.05]。结论 与经典桡动脉路径相比,经远端桡动脉路径行冠状动脉介入诊疗安全有效,可以降低桡动脉闭塞情况,可能成为经典路径的一个替代支路。

    Abstract:

    Aim To evaluate the safety and effectiveness of percutaneous coronary intervention via distal transradial artery access. Methods Pubmed, Embase, Web of Science, Cochrane Library, China Biomedical Service System (Sinomed), China Knowledge Network (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), VIP and other databases were searched by computer. The search time limit was from Janurary 2017 to May 2020. Two researchers conducted a Meta-analysis after analyzing and evaluating according to the Cochrance bias risk assessment tool.Results A total of 1 617 articles were obtained in various databases and other channels according to a predetermined search strategy, excluding unreasonable research design, no control group or control group as other parts of blood vessels (such as femoral artery, etc.), animal experiments, reviews, systematic reviews, and case reports were excluded. 10 articles were finally selected, Meta analysis results showed that there was no significant difference in the success rate of coronary puncture, the radial artery spasticity, and local hematoma (P>0.05). However, the the radial artery occlusion was lower (OR=0.4,5%CI(0.8,0.69),Z=3.56,P<0.05) in the distal radial artery path than in the traditional radial artery pathology. Conclusion Distal transradial artery access is safer and more effective than traditional radial artery access for coronary artery intervention. It can reduce radial artery occlusion and can be used as an alternative branch of the traditional route.

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牛绍乾,张晓晴,汪雁博,李伟,傅向华.经远端桡动脉路径行冠状动脉介入诊疗的Meta分析[J].中国动脉硬化杂志,2021,29(5):440~445.

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  • 收稿日期:2020-06-08
  • 最后修改日期:2020-07-02
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  • 在线发布日期: 2021-04-23