摘要
目的评估经皮切割球囊血管成形术(percutaneous cutting balloon angioplasty,PCB)治疗血透通路狭窄的疗效和安全性,为临床治疗和开展相关研究提供参考和帮助。方法截至2018年8月,检索Pubmed、Embase、Cochrane、中国知网、万方和维普等数据库,全面收集有关血透通路狭窄和经皮球囊血管成形术(percutaneous balloon angioplasty,PTA)的相关文献。制定文献纳入及排除标准,并制定效应指标的评价标准。由2名研究者分别独立筛选文献,用Cochrane风险偏倚评估工具评价纳入文献的质量。应用Review Manager5.3软件进行Meta分析。结果共检索到相关中文、外文文献58篇,从中筛选出随机临床试验(randomized clinical trials,RCT)的文献4篇,对PCB和PTA结果进行了头对头比较:共有1073名参与者,其中PCB 544人,PTA 529人。PCB比PTA的6个月狭窄血管通畅率明显更高(65.93%vs 55.11%;RD=0.11;95%CI:0.05-0.16;P=0.0002)。PCB与PTA的手术成功率相比,差异没有统计学意义(87.68%vs 84.31%;RD=0.03;95%CI:-0.01-0.08;P=0.10)。PCB与PTA的并发症发生率相比,差异没有统计学意义(0.026%vs0.004%;RD=0.03;95%CI:-0.01-0.07;P=0.19)。结论PCB治疗血透通路狭窄具有良好的疗效和安全性;在血透通路狭窄的治疗中是一种较为理想的选择。
Objective To evaluate the safety and efficacy of percutaneous cutting balloon angioplasty(PCB)in the treatment of hemodialysis stenosis,and to provide reference and help for clinical treatment and related research.Methods Databases such as Pubmed,Embase,Cochrane,China Knowledge Network,Wanfang,and Weipu were searched up to August 2018 for relevant literature on hemodialysis stenosis and percutaneous balloon angioplasty(PTA).The document inclusion and exclusion criteria and evaluation criteria for effect indicators were given out.Two investigators independently screened the literature and evaluated the quality of the included literature with Cochrane Risk Bias Evaluation Tool.Results A total of 58 relevant Chinese and foreign literatures were retrieved,including four randomized clinical trials(RCT).The PCB and PTA results were compared head-to-head:a total of 1073 participants,including 544 PCB and 529 PTA people.The 6-month stenotic patency rate of PCB was significantly higher than that of PTA(65.93%vs 55.11%;RD=0.11;95%CI:0.05-0.16;P=0.0002).There was no statistically significant difference in the success rate of PCB versus PTA(87.68%vs 84.31%;RD=0.03;95%CI:-0.01-0.08;P=0.10).There was no statistically significant difference in complications rates of PCB and PTA(0.026%vs 0.004%;RD=0.03;95%CI:-0.01-0.07;P=0.19).Conclusion PCB treatment of hemodialysis pathway stenosis has good efficacy and safety;it is an ideal choice in the treatment of hemodialysis stenosis.
作者
何金森
卢林琪
姚颖
He Jinsen;Lu Linqi;Yao Ying(Department of Nephrology,Nanping First Hospital affiliated to Fujian Medical University,Nanping 353000,China;Department of Nephrology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan430000,China)
出处
《临床荟萃》
CAS
2019年第11期1004-1009,共6页
Clinical Focus
基金
福建省卫生计生青年科研课题B类——galunisertib在UUO小鼠肾间质纤维化中的肾脏保护作用及机制(2016-2-56)
