【摘要】 目的评价微型体外循环与传统体外循环对心脏手术术后死亡率与不良心血管事件的影响。方法采用Cochrane系统评价方法 ,检索Pubmed、Embase、Cochrane database数据库,纳入心脏手术术中微型体外循环与传统体外循环对术后影响的随机对照试验,采用Rev Man 5.2软件进行数据分析。结果共纳入24个研究共2770例患者。Meta分析结果显示,与传统体外循环比较,微型体外循环可减低术后死亡率(OR 0.40,95%CI 0.18,0.88),差异有统计学意义;与传统体外循环比较,微型体外循环可降低术后心肌梗死发病率(OR 0.33,95%CI 0.12,0.90)、降低输血率(OR 0.24,95%CI 0.16,0.37)、降低心衰的发生率(OR 0.52,95%CI 0.32,0.84)、降低术后房颤的发生率(OR 0.66,95%CI 0.48,0.91)等不良心血管事件,差异均有统计学意义。结论心脏手术术中使用微型体外循环可降低术后的死亡率及不良心血管事件的发生率。更多还原

【Abstract】 Objective To evaluate the impact of minimal extracorporeal circulation(MECC) compared to conventional extracorporeal circulation(CECC) on mortality and major adverse cardiovascular events in patients undergoing heart surgery. Methods Used Cochrane systemic review, we conducted systematic search of Pubmed, Embase and Cochrane databases to include randomized controlled trials(RCTs) of MECC vs. CECC in patients with heart surgery. Rev Man5.2 software was used for data analysis. Results Twenty-four prospective RCTs have been included(2770 patients).MECC significantly decrease mortality(OR 0.40,95%CI 0.18,0.88). And MECC significantly decrease postoperative myocardial infarction(OR 0.33,95%CI 0.12,0.90), need for red blood cell transfusion(OR 0.24,95%CI 0.16,0.37),need for inotropic support(OR 0.52,95%CI 0.32,0.84), and postoperative atrial fibrillation(OR 0.66,95%CI 0.48,0.91). Conclusion Using of MECC in heart surgery resulted in improved short-term outcome as reflected by reduced mortality and morbidity compared with CECC.更多还原