Abstract：
OBJECTIVE: Data on bilateral internal mammary artery (BIMA) versus single internal mammary artery (SIMA) on diabetics were analyzed; This is the only meta-analysis, the last 7 years.
METHODS: Medline through PubMed/EMBASE/CINHAL and the Cochrane Central Register of Controlled Trials; 179 articles were studied; 19 studies deemed suitable and were included in the analysis.
RESULTS: The mortality was 2.41% for BIMA versus 1.71% for SIMA (odds ratio [OR] = 0.95; 95% confidence interval [CI]: 0.74-1.22). Postoperative reopening for bleeding was higher at 3.75% for BIMA versus 2.91% for SIMA (OR = 1.49; 95% CI: 1.15-1.93). The incidence of MI was 0.87% for BIMA versus 0.83% for SIMA (OR = 0.73; 95% CI: 0.37-1.44). Deep sternal wound infection was 3.02% for BIMA and 1.95% for SIMA (OR = 1.57; 95% CI: 1.26-1.95). When skeletonized, the incidence of DSWI was 2.5% for BIMA versus 2.41% for SIMA. There was a significant difference at 5-year survival favoring the BIMA, 85.15% BIMA versus 80.77% SIMA (OR = 1.79; 95% CI: 1.60-2.01). The 10-year overall survival was 74.04% BIMA versus 61.57% SIMA (OR = 1.79; 95% CI: 1.61-1.98). The 15-year survival was 47.08% for BIMA versus 37.06% for SIMA (OR = 1.69; 95% CI: 1.52-1.88).
CONCLUSIONS: Postoperative bleeding was higher in BIMA group. Bilateral internal mammary artery in diabetic patients should be carried out in a skeletonize fashion, to reduce DSWI. There is a survival benefit of using BIMA in diabetics within 5 years of surgery; it remains significant up to 15 years.
METHODS: Medline through PubMed/EMBASE/CINHAL and the Cochrane Central Register of Controlled Trials; 179 articles were studied; 19 studies deemed suitable and were included in the analysis.
RESULTS: The mortality was 2.41% for BIMA versus 1.71% for SIMA (odds ratio [OR] = 0.95; 95% confidence interval [CI]: 0.74-1.22). Postoperative reopening for bleeding was higher at 3.75% for BIMA versus 2.91% for SIMA (OR = 1.49; 95% CI: 1.15-1.93). The incidence of MI was 0.87% for BIMA versus 0.83% for SIMA (OR = 0.73; 95% CI: 0.37-1.44). Deep sternal wound infection was 3.02% for BIMA and 1.95% for SIMA (OR = 1.57; 95% CI: 1.26-1.95). When skeletonized, the incidence of DSWI was 2.5% for BIMA versus 2.41% for SIMA. There was a significant difference at 5-year survival favoring the BIMA, 85.15% BIMA versus 80.77% SIMA (OR = 1.79; 95% CI: 1.60-2.01). The 10-year overall survival was 74.04% BIMA versus 61.57% SIMA (OR = 1.79; 95% CI: 1.61-1.98). The 15-year survival was 47.08% for BIMA versus 37.06% for SIMA (OR = 1.69; 95% CI: 1.52-1.88).
CONCLUSIONS: Postoperative bleeding was higher in BIMA group. Bilateral internal mammary artery in diabetic patients should be carried out in a skeletonize fashion, to reduce DSWI. There is a survival benefit of using BIMA in diabetics within 5 years of surgery; it remains significant up to 15 years.
摘要：
目的：分析了糖尿病患者的双侧乳内动脉（BIMA）与单个乳内动脉（SIMA）的数据；这是唯一的荟萃分析，过去的7年。
方法：Medline通过PubMed/EMBASE/CINHAL和Cochrane中央对照试验注册；研究了179篇文章；19项研究认为合适并纳入分析。
结果：BIMA的死亡率为2.41%，SIMA为1.71%（比值比[OR]=0.95；95%置信区间[CI]：0.74-1.22）。BIMA术后再次出血的发生率较高，为3.75％，而SIMA为2.91％（OR=1.49；95％CI：1.15-1.93）。BIMA的MI发生率为0.87%，SIMA为0.83%（OR=0.73；95%CI：0.37-1.44）。胸骨深部伤口感染BIMA为3.02％，SIMA为1.95％（OR=1.57；95％CI：1.26-1.95）。当骨架化的时候，DSWI的发生率BIMA为2.5%,SIMA为2.41%.有利于BIMA的5年生存率存在显着差异，BIMA为85.15%，SIMA为80.77%（OR=1.79；95%CI：1.60-2.01）。10年总生存率为74.04%BIMA和61.57%SIMA(OR=1.79;95%CI:1.61-1.98)。BIMA的15年生存率为47.08％，SIMA为37.06％（OR=1.69；95％CI：1.52-1.88）。
结论：BIMA组术后出血较高。糖尿病患者的双侧乳内动脉应以骨骼化的方式进行，减少DSWI。在手术后5年内，在糖尿病患者中使用BIMA具有生存益处；直到15年，它仍然很重要。
方法：Medline通过PubMed/EMBASE/CINHAL和Cochrane中央对照试验注册；研究了179篇文章；19项研究认为合适并纳入分析。
结果：BIMA的死亡率为2.41%，SIMA为1.71%（比值比[OR]=0.95；95%置信区间[CI]：0.74-1.22）。BIMA术后再次出血的发生率较高，为3.75％，而SIMA为2.91％（OR=1.49；95％CI：1.15-1.93）。BIMA的MI发生率为0.87%，SIMA为0.83%（OR=0.73；95%CI：0.37-1.44）。胸骨深部伤口感染BIMA为3.02％，SIMA为1.95％（OR=1.57；95％CI：1.26-1.95）。当骨架化的时候，DSWI的发生率BIMA为2.5%,SIMA为2.41%.有利于BIMA的5年生存率存在显着差异，BIMA为85.15%，SIMA为80.77%（OR=1.79；95%CI：1.60-2.01）。10年总生存率为74.04%BIMA和61.57%SIMA(OR=1.79;95%CI:1.61-1.98)。BIMA的15年生存率为47.08％，SIMA为37.06％（OR=1.69；95％CI：1.52-1.88）。
结论：BIMA组术后出血较高。糖尿病患者的双侧乳内动脉应以骨骼化的方式进行，减少DSWI。在手术后5年内，在糖尿病患者中使用BIMA具有生存益处；直到15年，它仍然很重要。
