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无心脏起器与静脉输入心脏起器在末期病患者:系统性审查和分析
Ștefan Bogdan1,2,3, Mircea Ioan Alexandru Bistriceanu1, Cosmin Gabriel Ursu1
1Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Biomedicines
|August 28, 2025
概括
无心脏起器 (LPM) 在末期病 (ESRD) 患者中没有降低整体并发症或早期死亡率. 这种LPM与接触部位,血栓和呼吸道并发症的风险较高有关.
科学领域:
- 心脏病学
- 肝脏病学
- 医疗器械
背景情况:
- 患有末期病 (ESRD) 的患者在心脏起器植入后面临与器件相关的并发症的风险增加.
- 无心脏起器 (LPM) 具有潜在的益处,但它们在ESRD患者中的安全性和有效性需要彻底评估.
- 通过静脉输入的心脏起器 (TVP) 是传统的标准,在这个人群中具有自己的风险.
研究的目的:
- 在ESRD患者中比较LPM和TVP的临床结果和并发症概况.
- 在高风险患者群体中评估LPM作为TVP的替代品的安全性和有效性.
- 为优化ESRD患者的心脏起器选择提供数据驱动的见解.
主要方法:
- 根据PRISMA指南进行系统审查和元分析.
- 在ESRD患者中对LPM和TVP进行了三项回顾性研究.
- 分析主要终点 (总体并发症) 和次要结果,包括早期死亡率,接入部位并发症,与设备相关的事件,血栓事件和呼吸道并发症.
主要成果:
- 在LPM和TVP组之间,整体并发症或早期死亡率没有显著差异.
- 这种LPM与显著增加的入口部位并发症 (OR 2.51),血栓事件 (OR 1.42) 和呼吸道并发症 (OR 1.43) 相关.
- 在这两种心脏起器类型中,与设备相关的并发症率是可比的.
结论:
- 在ESRD患者中,与TVP相比,LPMs没有减少整体并发症或短期死亡率.
- 在这一群体中,LPM与特定程序并发症的风险增加有关.
- 结果表明需要个性化设备选择和进一步的前性研究来指导ESRD患者使用心脏起器的临床决策.
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