与心脏导管术后标准手动压缩相比,动脉穿孔关闭装置:系统性审查和元分析
Maria Koreny1, Eva Riedmüller, Mariam Nikfardjam
1Department of Emergency Medicine, University of Vienna, Vienna General Hospital, Vienna, Austria.
JAMA
|January 22, 2004
概括
动脉穿孔关闭装置 (APCD) 可能提供边际好处,但引起了人们的关注. 这一元分析表明,APCD可能会增加血液瘤和伪动脉瘤的风险,质疑它们的整体疗效和安全性.
科学领域:
- 心血管干预 心血管干预
- 医疗器械技术 医疗器械技术
- 基于证据的医学基于证据的医学.
背景情况:
- 动脉穿刺关闭装置 (APCD) 是为了改善皮肤穿刺冠状动脉干预后患者的治疗结果而开发的.
- APCD的目的是取代手动压缩,减少患者的康复时间.
研究的目的:
- 与标准手动压缩相比,评估各种APCD的安全性和有效性.
- 该研究的重点是接受冠状动脉血管学或皮肤血管干预的患者.
主要方法:
- 在多个数据库 (MEDLINE,EMBASE等) 中进行了系统的文献搜索. 和科克兰登记册.
- 包括随机对照试验评估血管并发症和疗效指标,如血液静止的时间.
- 数据是独立抽象的,随机效应模型被用于聚合分析,注意方法质量.
主要成果:
- 分析了涉及多达4000名患者的30项试验.
- 总的来说,与手动压缩相比,APCDs没有显著增加血液瘤,出血,动脉静脉或伪动脉瘤.
- 然而,APCD显著减少了血液静止的时间,但在使用治疗意图原则分析时,与血液瘤和伪动脉瘤的风险增加有关.
结论:
- 这一对30项随机试验的元分析,其中许多试验质量不佳,为APCD的有效性提供了有限的证据.
- 人们担心,APCD可能会增加血液瘤和伪动脉瘤形成的风险.
- 需要进一步进行高质量的研究,以确定APCD的安全性和有效性.
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