急性四肢缺血患者的内血管与开放手术方法:系统性审查和元分析
Maram Abuajamieh1, Mohammed S Beshr2, Abdelaziz H Salama3
1Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Journal of vascular surgery
|November 13, 2025
概括
对急性四肢缺血的内血管和开放手术显示了类似的早期结果. 内血管治疗提供更好的长期存活率和更短的住院时间,但具有更高的内出血风险.
科学领域:
- 血管外科 血管外科
- 干预心脏病学 干预心脏病学
- 医疗技术评估 医疗技术评估
背景情况:
- 急性四肢缺血症 (ALI) 是一种急性病症,需要迅速重新血管化.
- 内血管技术和开放外科手术都用于治疗ALI.
- 比较有效性数据对于指导治疗决策至关重要.
研究的目的:
- 为了比较临床结果和内血管和ALI的开放外科手术技术的手术并发症.
- 综合现有研究的证据,以告知临床实践.
主要方法:
- 对比内血管干预与ALI的开放外科手术技术的研究进行了全面的元分析.
- 在主要数据库 (PubMed,Embase,Cochrane图书馆,Scopus,ClinicalTrials.gov) 进行系统搜索.
- 包括26项研究 (4项RCT,22项队列研究),涉及214,683名患者.
主要成果:
- 早期或长期截肢率没有显著差异.
- 类似的早期和6个月死亡率;内血管治疗显示改善了长期存活率.
- 较短的住院时间和较低的感染率与内血管治疗.
- 脑内出血的风险增加与内血管治疗,而其他并发症是相似的.
结论:
- 内血管和开放的复血管化证明了对ALI的早期结果相似.
- 血管内治疗对长期生存,住院和感染率都有好处.
- 由于研究异质性和有限的RCT,随着内血管方法的内出血风险更高,需要进一步进行高质量的研究.
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