發(fā)布時(shí)間：2018-04-04 07:25

  本文選題：頸動(dòng)脈內(nèi)膜剝脫　切入點(diǎn)：抗血小板　出處：《臨床麻醉學(xué)雜志》2017年05期

【摘要】：目的采用Meta分析比較頸動(dòng)脈內(nèi)膜剝脫術(shù)(carotid endarterectomy,CEA)患者術(shù)前持續(xù)服用抗血小板藥物對(duì)術(shù)后出血的影響。方法檢索Pubmed、Cochrane Library、Embase數(shù)據(jù)庫(kù)、中國(guó)知網(wǎng)(CNKI)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、萬(wàn)方數(shù)據(jù)庫(kù)和維普期刊網(wǎng),時(shí)間從建庫(kù)至2017年2月。收集所有關(guān)于術(shù)前服用抗血小板藥物與CEA術(shù)后出血的隨機(jī)對(duì)照試驗(yàn)(RCT)研究。采用Cochrane協(xié)作網(wǎng)系統(tǒng)評(píng)價(jià)法評(píng)價(jià)文獻(xiàn)質(zhì)量,采用RevMan 5.3軟件對(duì)收集患者資料進(jìn)行Meta分析評(píng)價(jià)。結(jié)果最終納入4篇RCT,共514例患者,其中安慰劑組256例,干預(yù)組258例。所有結(jié)局指標(biāo)各項(xiàng)研究結(jié)果無(wú)異質(zhì)性(P0.1,I250%),采用固定效應(yīng)模型分析。CEA術(shù)前持續(xù)服用抗血小板藥物可明顯降低CEA術(shù)后腦卒中風(fēng)險(xiǎn)(RR=0.30,95%CI 0.11~0.83,P=0.02)。兩組術(shù)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(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論頸動(dòng)脈內(nèi)膜剝脫術(shù)前持續(xù)服用阿司匹林不增加術(shù)后出血并發(fā)癥風(fēng)險(xiǎn),但可明顯降低術(shù)后腦卒中風(fēng)險(xiǎn)。
[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(hào)：1708952