本文選題：頸動脈內膜剝脫　切入點：抗血小板　出處：《臨床麻醉學雜志》2017年05期

【摘要】：目的采用Meta分析比較頸動脈內膜剝脫術(carotid endarterectomy,CEA)患者術前持續(xù)服用抗血小板藥物對術后出血的影響。方法檢索Pubmed、Cochrane Library、Embase數據庫、中國知網(CNKI)、中國生物醫(yī)學文獻數據庫(CBM)、萬方數據庫和維普期刊網,時間從建庫至2017年2月。收集所有關于術前服用抗血小板藥物與CEA術后出血的隨機對照試驗(RCT)研究。采用Cochrane協(xié)作網系統(tǒng)評價法評價文獻質量,采用RevMan 5.3軟件對收集患者資料進行Meta分析評價。結果最終納入4篇RCT,共514例患者,其中安慰劑組256例,干預組258例。所有結局指標各項研究結果無異質性(P0.1,I250%),采用固定效應模型分析。CEA術前持續(xù)服用抗血小板藥物可明顯降低CEA術后腦卒中風險(RR=0.30,95%CI 0.11~0.83,P=0.02)。兩組術后30d(RR=0.23,95%CI 0.04~1.32,P=0.1)及1年全因死亡率(RR=0.49,95%CI 0.24~1.02,P=0.06)、大出血發(fā)生率(RR=1.40,95%CI 0.54~3.59,P=0.49)和出血并發(fā)癥發(fā)生率(RR=1.02,95%CI0.15~6.96,P=0.98)及TIA發(fā)生率(RR=1.08,95%CI 0.47~2.49,P=0.86)差異無統(tǒng)計學意義。結論頸動脈內膜剝脫術前持續(xù)服用阿司匹林不增加術后出血并發(fā)癥風險,但可明顯降低術后腦卒中風險。
[Abstract]:Objective to compare the effect of continuous anti-platelet drugs on postoperative bleeding in patients with carotid endarterectomy by Meta analysis.Methods We searched the Pubmedan Cochrane Library Embase database, CNKIN, CBMN, Wanfang database and Weipu Journal Network, from the time of establishment to February 2017.All randomized controlled trial RCTs about preoperative antiplatelet drugs and postoperative bleeding after CEA were collected.The literature quality was evaluated by Cochrane system evaluation method and Meta analysis and evaluation by RevMan 5.3 software.Results A total of 514 patients were included in 4 RCTs, including 256 patients in placebo group and 258 patients in intervention group.According to the fixed effect model analysis, continuous administration of antiplatelet drugs before and after CEA could significantly reduce the risk of stroke after CEA.涓ょ粍鏈悗30d(RR=0.23,95%CI 0.04~1.32,P=0.1)鍙，

本文編號：1708952