生物假肢与机械在70岁以下的患者中进行关节置换:更新的对对元分析
Adham Ahmed1, Ahmed K Awad2, Kathryn S Varghese3
1CUNY School of Medicine, 1589 Amsterdam Avenue, New York, NY, 10031, USA. aahmed018@citymail.cuny.edu.
General thoracic and cardiovascular surgery
|July 6, 2023
概括
在70岁以下的患者中,机械膜 (MMV) 显示较低的30天和长期死亡率比生物假体膜 (BPV). 在中风,再手术或出血风险方面没有发现显著差异.
科学领域:
- 心血管外科心血管外科
- 生物医学工程 生物医学工程
- 临床结果研究研究
背景情况:
- 对于额头置换 (MVR) 的人造的最佳选择是有争议的,特别是对于年轻的患者,他们的预期寿命更长.
- 生物假体门 (BPV) 和机械门 (MMV) 是主要的选择,每个都有明显的优点和缺点.
研究的目的:
- 在接受MVR的70岁以下患者中,比较BPV与MMV的安全性和有效性.
- 在较年轻的MVR人群中为假体门选择提供基于证据的指导.
主要方法:
- 在主要的医学数据库中进行了系统的文献搜索.
- 使用Mantle-Haenszel方法对15项研究的数据进行了一项双对元分析.
- 结果是使用随机效应模型进行聚合,报告风险比率 (RR) 与95%置信区间 (95% CI).
主要成果:
- 分析包括了16879名患者.
- 生物假体门 (BPV) 与机械门 (MMV) 相比,与30天死亡率 (RR 1.53) 显著增加有关.
- 在长期随访 (平均14.1年) 时,BPV也显示出更高的死亡率 (RR 1.28),但在中风,再手术或严重出血风险方面,BPV和MMV之间没有发现显著差异.
结论:
- 与生物假肢 (BPV) 相比,机械关 (MMV) 与接受关置换的70岁以下患者的30天和长期死亡率降低有关.
- 在两种门类型之间,在中风,重新手术或严重出血的风险上没有发现显著差异.
- 这些发现表明MMV对年轻患者的潜在益处,尽管需要进一步的随机对照试验.
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