体外与非体外循环下冠状动脉旁路移植术疗效比较的荟萃分析

目的使用Meta分析比较非体外循环下冠状动脉旁路移植术(OPCAB)和常规体外循环下冠状动脉旁路移植术(CCAB)对冠状动脉粥样硬化性心脏病的治疗效果。方法检索2006～2010国内关于非体外循环下冠状动脉旁路移植术和体外循环下冠状动脉旁路移植术手术后疗效分析的临床研究,收集相关数据并用RevMan 5.1统计软件进行Meta分析。结果检索并纳入本次研究的文献共16篇,合计病例2687例(OPCAB组1489例,CCAB组1198例)。Meta分析结果示,非体外循环下冠状动脉旁路移植组在术后引流量、输血量、呼吸机辅助时间、留住ICU时间、住院时间、术后并发症发生率上都明显低于体外循环下冠状动脉旁路移植组(P<0.05),而两组在年龄和移植血管数上无显著性差异(P>0.05)。结论近期观察非体外循环下冠状动脉旁路移植术治疗冠状动脉病变比体外循环下冠状动脉旁路移植治疗效果更好。

Summary of Comparison of Therapeutic Effects between Off-pump and On-pump Coronary Artery Bypass Grafting

Objective To systematically review and meta-analyze the randomized and nonrandomized evidence comparing off-pump coronary artery bypass(OPCAB)to conventional coronary artery bypass(CCAB)surgery.Methods The comparative studies regarding therapeutic effects of OPCAB and CCAB from 2006 to 2010 were retrieved,and the relevant data was Meta analyzed using RevMan 5.1 statistical software.Results A total of 16 literatures were included in this study,including 1 489 cases in the OPCAB group and 1 198 cases in the CCAB group.Results of Meta analysis demonstrated that,OPCAB was superior to CCAB in postoperative drainage volume,blood transfusion volume,the duration of ventilation,ICU and hospital stay,and postoperative complications(P<0.05).However,the graft number and the age had no difference between the two groups(P>0.05).Conclusion The results revealed that compared with CCAB,OPCAB receives superior short term outcome in the treatment of coronary artery disease.