经胸微创封堵与传统外科手术治疗室间隔缺损的Meta分析

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Abstract Objective To systematically review the efficacy and safety of minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects. Methods The controlled trials concerning minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects published at home and abroad were collected through searching medical databases such as MEDLINE, PubMed, Ovid, CNKI, CSCD, WanFang Data, CBM, using "ventricular septal defects, cardiopulmonary bypass, surgical repair, transthoracic device closure, perventricular device occlusion, perventricular device closure" for retrieval words from the date of establishment of the databases to November 2016. A meta-analysis was performed by using RevMan 5.3. Results Total 16 studies with 3879 patients were enrolled in this study. Meta analysis results showed that the operation success rate in the minimally invasive transthoracic device closure group was less than that of surgical repair group (OR = 0.14, 95%CI: 0.08-0.24, P ＜ 0.01), while the incidence of postoperative complications was lower than that of surgical repair group (OR = 0.51, 95%CI: 0.30-0.86, P = 0.01). The mortality rates and the hospitalization expenses were similar in both groups. The operation time (MD = -64.69, 95%CI: -73.41 - -55.96, P ＜ 0.01), postoperative respiratory machine auxiliary breathing time (MD = -6.94, 95%CI: -8.82 - -5.06, P ＜ 0.01) and the total length of hospital stay (MD = -2.30, 95%CI: -3.30 - -1.31, P ＜ 0.01) in the minimally invasive transthoracic device closure group were significantly shorter than those of surgical repair group, the differences were statistically significant. Conclusion Minimally invasive transthoracic device closure is simple, safe, with small trauma, rapid recovery compared with conventional surgical repair, which is an effective method in the treatment of ventricular septal defects within the scope of the indications.

Key words： Ventricular septal defect Minimally invasive transthoracic device closure Surgical repair Cardiopulmonary bypass

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	TAN Qiming QIN Liangguang YU Bo CHEN Hongye ZHANG Jie LIU Jinping

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TAN Qiming QIN Liangguang YU Bo CHEN Hongye ZHANG Jie LIU Jinping. Minimally invasive transthoracic device closure versus conventional surgical repair in the treatment of ventricular septal defects: a Meta-analysis[J]. 中国医药导报, 2017, 14(20): 48-53.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2017/V14/I20/48

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