冷冻球囊消融相对于冷盐水灌注导管射频消融治疗心房纤颤的系统评价-内科学(心血管)专业论文.docxVIP

福建医科大学 福建医科大学 万方数据 万方数据 目录 缩略词表·················································1 中文摘要·················································2 英文摘要·················································3 前 言·················································4 材料方法·················································5 结 果·················································7 讨 论·················································22 结 论·················································25 参考文献·················································26 致 谢·················································28 综 述·················································29 缩略词表 缩写 英文全称 中文全称 BMI Body mass index 体重指数 CBA Cryoballoon ablation 冷冻球囊消融 CCT Controlled clinical trail 临床对照试验 CI Confidence interval 可信区间 IRA LVEF Irrigated radiofrequency Left ventricular ejection ablation fraction 冷盐水灌注导管射频消融 左室射血分数 WMD OR Weighed mean difference Odds ratio 权重均数差 比值比 PAF PeAF PNP PVI Paroxysmal atrial fibrillation Persistent atrial fibrillation Phrenic nerve paralysis Pulmonary vein isolation 阵发性心房纤颤 持续性心房纤颤 膈神经麻痹 肺静脉隔离 RCT RD Randomized controlled trail Risk difference 随机对照实验 风险差异 RR Risk ratio 相对危险度 1 冷冻球囊消融相对于冷盐水灌注导管射频消融 治疗心房纤颤的系统评价 中文摘要 目的 系统评价冷冻球囊消融（Cryoballoon Ablation，CBA）与冷盐水灌注导管 射频消融（Irrigated Radiofrequency Ablation，IRA）治疗心房纤颤的有效性、安 全性的差异。 方法 检索比较 CBA 与 IRA 治疗心房纤颤的临床对照研究，提取手术时间、X 线照射时间、肺静脉隔离成功率、房颤复发率、主要并发症发生率等数据，使用 STATA 12.0 软件对所提取的数据进行 Meta 分析。 结果 共纳入 12 项研究，共 1052 例患者，Meta 分析结果显示：在房颤的治疗 中， CBA 组 相 对 于 IRA 组 手 术 时 间 缩 短 [P0.001 ， WMD=19.68 ， 95%CI(-26.73,-12.62)] ， 肺 静 脉 隔 离 失 败 率 增 加 [P=0.008,RR=4.90 ， 95%CI(1.52,15.81)]，可逆性膈神经麻痹（Phrenic Nerve Paralysis，PNP）发生率 增加[P0.001,RR=5.48,95%CI(2.17,13.86)], 而在其他主要并发症发生率及房颤复 发率方面，两组之间的差异无统计学意义（均 P0.05）。 结论 冷冻球囊消融是房颤导管消融的一种有效而安全的手术方式，但仍有待进 一步改进和发展。 关键词 心房纤颤，冷冻球囊，射频消融，Meta 分析，系统评价 2 A Systematic Review on the Comparison between Cryoballoon Ablation and Irrigated Radiofrequency Ablation in the Treatment of Atrial Fibrillation Abstract Objective To evaluate th