UNASSIGNED:进行了一项随机对照试验的荟萃分析,以比较小型化体外循环(MECC)和常规体外循环(CECC)对心脏手术后发病率和死亡率的影响。
UNASSIGNED:使用Ovid进行了全面的文献检索,PubMed,Medline,EMBASE,和Cochrane数据库.考虑了2000年以来n>40例患者的随机对照试验。关键搜索词包括“迷你”的变体,“\”心肺,\"\"旁路,\"\"体外,\"\"灌注,\"和\"电路。“使用Cochrane偏差风险工具评估研究的偏差。主要结果是术后死亡率和卒中。次要结果包括心律失常,心肌梗塞,肾功能衰竭,失血,以及由死亡率组成的复合结果,中风,心肌梗死和肾衰竭。重症监护室的持续时间,住院时间也有记录。
UNASSIGNED:符合本研究条件的42项研究共包括2154名接受CECC的患者和2196名接受MECC的患者。术前或人口统计学特征均无显著差异。与CECC相比,MECC没有降低死亡率,中风,心肌梗塞,和肾功能衰竭,但确实显着降低了这些结局的综合(比值比,0.64;95%置信区间[CI],0.50-0.81;P=.0002)。MECC还与心律失常的减少相关(比值比,0.67;95%CI,0.54-0.83;P=.0003),失血量(平均差[MD],-96.37mL;95%CI,-152.70至-40.05mL;P=.0008),住院时间(MD,-0.70天;95%CI,-1.21至-0.20天;P=.006),和重症监护病房住院(MD,-2.27小时;95%CI,-3.03至-1.50小时;P<.001)。
UNASSIGNED:与CECC相比,MECC显示出临床益处。需要进一步的研究来进行成本效用分析并评估MECC的长期结果。这些应使用终点的标准化定义,例如死亡率和肾衰竭,以减少结果报告中的不一致。
UNASSIGNED: A meta-analysis of randomized controlled trials was performed to compare the effects of miniaturized extracorporeal circulation (MECC) and conventional extracorporeal circulation (CECC) on morbidity and mortality rates after cardiac surgery.
UNASSIGNED: A comprehensive literature search was conducted using Ovid, PubMed, Medline, EMBASE, and the Cochrane databases. Randomized controlled trials from the year 2000 with n > 40 patients were considered. Key search terms included variations of \"mini,\" \"cardiopulmonary,\" \"bypass,\" \"extracorporeal,\" \"perfusion,\" and \"circuit.\" Studies were assessed for bias using the Cochrane Risk of Bias tool. The primary outcomes were postoperative mortality and stroke. Secondary outcomes included arrhythmia, myocardial infarction, renal failure, blood loss, and a composite outcome comprised of mortality, stroke, myocardial infarction and renal failure. Duration of intensive care unit, and hospital stay was also recorded.
UNASSIGNED: The 42 studies eligible for this study included a total of 2154 patients who underwent CECC and 2196 patients who underwent MECC. There were no significant differences in any preoperative or demographic characteristics. Compared with CECC, MECC did not reduce the incidence of mortality, stroke, myocardial infarction, and renal failure but did significantly decrease the composite of these outcomes (odds ratio, 0.64; 95% confidence interval [CI], 0.50-0.81; P = .0002). MECC was also associated with reductions in arrhythmia (odds ratio, 0.67; 95% CI, 0.54-0.83; P = .0003), blood loss (mean difference [MD], -96.37 mL; 95% CI, -152.70 to -40.05 mL; P = .0008), hospital stay (MD, -0.70 days; 95% CI, -1.21 to -0.20 days; P = .006), and intensive care unit stay (MD, -2.27 hours; 95% CI, -3.03 to -1.50 hours; P < .001).
UNASSIGNED: MECC demonstrates clinical benefits compared with CECC. Further studies are required to perform a cost-utility analysis and to assess the long-term outcomes of MECC. These should use standardized definitions of endpoints such as mortality and renal failure to reduce inconsistency in outcome reporting.