系统综述

关于深低温停循环与中低温停循环联合选择性顺行性脑灌注的meta分析

Published at: 2014年第1卷第6期

David H. Tian 1 , Benjamin Wan 1 , Paul G. Bannon 2 , Martin Misfeld 3 , Scott A. LeMaire 4 , Teruhisa Kazui 5 , Nicholas T. Kouchoukos 6 , John A. Elefteriades 7 , Joseph Bavaria 8 , Joseph S. Coselli 4 , Randall B. Griepp 9 , Friedrich W. Mohr 3 , Aung Oo 10 , Lars G. Svensson 11 , G. Chad Hughes 12 , Tristan D. Yan 2
1 The Systematic Review Unit, The Collaborative Research (CORE) Group, Sydney, Australia
2 The Systematic Review Unit, The Collaborative Research (CORE) Group, Sydney, Australia; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
3 Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany
4 Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas, USA; Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
5 Cardiovascular Center, Hokkaido Ohno Hospital, Sapporo, Japan
6 Missouri Baptist Medical Center, St Louis, Missouri, USA
7 Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
8 Department of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, USA
9 Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, USA
10 Liverpool Heart and Chest Hospital, Liverpool, UK
11 Center for Aortic Surgery and Marfan and Connective Tissue Disorder Clinic, the Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland, Ohio, USA
12 Department of Surgery, Division of Cardiovascular and Thoracic Surgery, Duke University Medical Center, Durham, North Carolina, USA

摘要

背景:目前主动脉弓外科中深低温停循环(DHCA)有潜在的增加凝血异常的风险,增加炎症反应和脏器功能不全等并发症。中低温停循环(MHCA)联合选择性顺行性脑灌注(SACP)在维持足够神经保护同时可以消除深低温带来的潜在并发症。这篇meta分析主要旨在对主动脉外科中DHCA与 MHCA+SACP在神经保护方面的术后结果进行比较。 方法:从初始相关文献发表到2013年1月期间,对六个相关数据库进行电子搜索。根据最新达成的低温共识,两位文献查阅者独立的鉴别出所有关于比较DHCA 与MHCA+SACP的相关文章。根据设定的临床终点,对数据进行抽取和meta分析。 结果:这篇meta分析纳入9个有可比性的研究。中风发生率在中低温停循环联合选择性顺行性脑灌注的病人中明显降低,这些可比性结果主要通过观察短暂性神经障碍,死亡率,肾衰或者出血。罕见的和不一致的结果影响其他结果的分析。 结论:这篇meta分析表明在降低中风风险方面,中低温停循环联合选择性顺行性脑灌注有优势。

请购买后进行阅读
comments powered by Disqus