Heart:二尖瓣手术微创入路vs开胸术的倾向匹配分析

2018-12-18 xiangting MedSci原创

微创手术与二尖瓣手术患者良好的短期预后和相当的中期预后相关。

这项多中心研究目的是比较二尖瓣手术采用开胸术与微创手术的短期和中期结局。

对2008年1月至2016年12月三家英国医院进行的所有二尖瓣手术数据进行分析,这些手术伴或不伴三尖瓣房颤手术。考虑到微创手术与开胸术间的选择偏倚,进行不伴替换的一对一倾向得分卡尺匹配。主要结局指标是由Kaplan-Meier估计值总结的中期无再干预存活率,治疗组间使用分层对数秩检验进行比较。

研究期间共进行了2404例手术(1757例开胸术和647例微创手术)。倾向得分匹配产生了639个匹配对,并改善了所有31个协变量的平衡匹配(绝对标准平均差异<10%)。尽管手术时间较长,微创手术患者的输血需求较低(20.5%vs14.4%,p=0.005),术后中位住院时间缩短(7 vs 6天,p<0.001)。住院死亡率或术后卒中率无统计学差异。微创组8年时的无再干预存活率约为86.1%,开胸组为84.1%(p=0.40)。

微创手术与二尖瓣手术患者良好的短期预后和相当的中期预后相关。对于需要二尖瓣治疗的所有患者,应考虑采用微创方法,并且该方法应作为比较经导管二尖瓣技术的标准。

原始出处:

Stuart W Grant. Propensity-matched analysis of minimally invasive approach versus sternotomy for mitral valve surgery. Heart. 12 December 2018.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

 

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    2019-06-09 午夜星河

    学习了

    0

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    2018-12-20 vera_1203
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    2018-12-20 zhaojie88
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    2018-12-20 wwzzly
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    2018-12-20 slcumt
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    2018-12-18 flysky120

    二尖瓣治疗方案

    0

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