二尖瓣置换与二尖瓣修复在老年患者中的应用比较

尚小珂; 陈澍; 李飞; 王斌; 孙永丰; 李庚; 胡志伟; 周诚; 丁珊珊; 董念国

doi:10.13201/j.issn.1001-1439.2018.05.021

二尖瓣置换与二尖瓣修复在老年患者中的应用比较

- 华中科技大学同济医学院附属协和医院心外科(武汉, 430022)

详细信息

通讯作者: 董念国,E-mail:dongnianguo@hotmail.com

中图分类号: R542.5

收稿日期: 2017-12-25

修回日期: 2018-01-29

The application of mitral valve replacement and mitral valve repair in elderly patients

- Cardiac Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

More Information

Corresponding author: DONG Nianguo, E-mail: dongnianguo@hotmail.com

Received Date: 25 December 2017

Revised Date: 29 January 2018

摘要

摘要: 目的:比较二尖瓣修复与二尖瓣置换在老年患者中应用的优、劣势。方法:系统检索2017年2月以前PubMed、Cochrane图书馆和Scopus收录的相关文献, 纳入2000年以后发表的老年患者 (70岁以上) 二尖瓣修复与二尖瓣置换的研究, 进行Meta分析。结果:共检索出7项观察性临床研究, 包含1 809例患者。与二尖瓣置换相比, 二尖瓣修复的30d病死率 (RR:0.40;95%CI:0.25⁰.64) 显著降低、术后住院时间较短 (WMD:-1.47d, 95%CI:-2.47^-0.48)、术后并发症较少 (RR:0.69, 95%CI:0.56⁰.86)。二尖瓣修复后1年生存率 (RR:1.16, 95%CI:1.08¹.24) 和5年生存率 (RR:1.26, 95%CI:1.13¹.41) 均得到改善。两种手术方法之间的再手术发生率差异无统计学意义。结论:接受二尖瓣修复的老年患者早期和晚期结果均优于二尖瓣置换患者, 二尖瓣修复可能是70岁以上老年人二尖瓣手术的首选策略。
- 二尖瓣修复 /
- 二尖瓣置换 /
- 老年患者
Abstract: Objective: To compare mitral valve repair (MVP) versus mitral valve replacement (MVR) in elderly patients.Method: We systematically searched PubMed, the Cochrane Library, and Scopus up to February 2017 and scrutinized the references of relevant literatures.Only studies of MVP versus MVR in elderly patients (aged 70 years or older) that were published after 2000 were included.Result: The retrieval process yielded 7 observational clinical studies with 1 809 patients.Compared with MVR, MVP was associated with a significantly reduced 30-day mortality (RR:0.40;95%CI:0.25 to 0.64), with shorter duration of postoperative hospital stay (WMD:-1.47 d, 95%CI:-2.47 to-0.48) and less postoperative complications (RR:0.69, 95%CI:0.56 to 0.86).1-year (RR:1.16, 95%CI:1.08 to 1.24) and 5-year survival rates (RR:1.26, 95%CI:1.13 to 1.41) were improved after treatment of MVP.There was no difference in reoperations between these 2 surgery approaches.Conclusion: Elderly patients who receive MVP have better early and late outcomes than those undergo MVR.MVP may be the preferred strategy for mitral valve surgery in the elderly population.
- mitral valve repair /
- mitral valve replacement /
- elderly

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