风湿性心脏病二尖瓣成形术与置换术的系统评价

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Abstract Objective To evaluate the suitability of mitral valve repair (MVP) and mitral valve replacement (MVR) for treating rheumatic heart disease (RHD), in order to provide a guideline for clinical treatment. Methods The Cochrane Library, PubMed, EMbase, CBM, CNKI, VIP, and Wanfang databases had been searched from establishment of the data bases to February 2017 for all clinical trials comparing the outcomes of MVP and MVR for RHD. After being organized and evaluated, data were analyzed by using RevMan 5.3 statistical software. The 30-day mortality rate, long-term survival, reoperation rates and postoperative complications were evaluated by performing a Meta-analysis. Results There were 11 retrospective studies including 4287 patients (1465 MVP cases and 2822 MVR cases). The results of Meta-analysis, which showed that MVP had improved 30 day mortality (OR=0.51, 95%CI [0.34, 0.78], P=0.002), increased long-term survival (HR=0.71, 95%CI [0.55, 0.91], P=0.007), and reduced postoperative complications (HR=0.63, 95%CI [0.50, 0.80], P=0.0002). However, MVP had a significantly higher rate of reoperation (HR=2.03, 95%CI [1.71, 2.41], P < 0.00001). Conclusion MVP is superior to MVR for short-term and long-term survival and valve-related complications. It has higher possibility for MVP patients received to suffer from reoperation, but authors still recommend that RHD patients should be considered for MVP if it is technically feasible.

Key words： Rheumatic heart disease Mitral valve repair Mitral valve replacement Meta-analysis

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	LI Xingchen1 TANG Bufu2 LIU Jianzhou1 ZHANG Chaoji1▲

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LI Xingchen1 TANG Bufu2 LIU Jianzhou1 ZHANG Chaoji1▲. Meta analysis of mitral valve repair versus replacement in patients with rheumatic heart disease[J]. 中国医药导报, 2017, 14(32): 62-67.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I32/62

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