| 摘要: |
| 冠状动脉疾病（CAD）是全球人群发病率和死亡率的重要因素[1]，经皮冠状动脉介入治疗（PCI）是冠状动脉血管化最常用的策略，其能有效地缓解症状，保护缺血心肌和心脏功能，并改善这些患者的预后[2]。随着介入技术的普及和介入材料的进步，心脑血管及周围血管腔内治疗的数量呈逐年增长趋势，由穿刺导致的医源性假性动脉瘤发生逐渐增多，尤其是股动脉假性动脉瘤的发生，有报道其发生率约为0.3%-8%[3,4]。文献显示股动脉假性动脉瘤多数不能自愈，其不断长大可出现局部压迫，或瘤体破裂出血，或血栓形成进而脱落致远端肢体栓塞等，可能导致严重后果、甚至危及生命[5,6]。因此一旦确诊应及时、合理的干预以求减少或避免相关的并发症和后遗症。目前有局部压迫疗法、超声引导下压迫治疗(UGC)、超声引导下瘤腔注射凝血酶(UGTI)、外科手术行假性动脉瘤切除和动脉修补术等治疗方法。既往如1997年Liau等[7]研究主要为回顾性研究及小样本随机对照试验，本文全面检索国内外相关文献，系统评价UGTI和UGC两种方法的有效性和安全性以期为UGTI治疗股动脉假性动脉瘤提供较好临床证据。 |
| 关键词: 股动脉假性动脉瘤 超声引导 凝血酶 Meta分析 |
| DOI： |
| 投稿时间：2018-03-16修订日期：2018-03-16 |
| 基金项目: |
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| Ultrasound Guided Compression Versus Ultrasound Guided Thrombin Injection for the Treatment of Iatrogenic FemoralPseudoaneurysms: Meta-Analysis of ComparativeStudies |
| Li haihua |
| (The fifth people''s hospital of Chongqing) |
| Abstract: |
| Objective: To assess the effectiveness and safely of ultrasound guided thrombin injection (UGTI)) to treat iatrogenic femoral pseudoaneurysms.
Methods: The study design involved a systematic review of the literature and meta-analysis of comparative studies. The PubMed，EMbase，MEDLINE，the Cochrane Library,CMB and CNKI were searched up to november 2017,to collect the randomized controlled trials（RCTs）about the effectiveness and safely of ultrasound guided compression UGC) versus ultrasound guided thrombin injection (UGTI) to treat iatrogenic femoral pseudoaneurysms.The literature was using RevMan 5.3 software.
Results: Six randomized control trials were included in the analysis. Over all 140 and 140 subjects underwent UGC and UGTI respectively. The latter modality resulted in a significantly higher success rate (97.1% vs 67.1%, OR 11.9, 95% CI 4.6-30.4，P<0.01) while the complication rate for both techniques was low (4.3% vs 7.2%, OR 3.27, 95% CI 0.38-27.9，P=0.26>0.05).
Conclusion:Available evidence suggests that UGTI is superior in terms of efficacy and as safe as UGC and thus should be used as the primary modality for the treatment of post-catheterization femoral pseudoaneurysms |
| Key words: Femoral pseudoaneurysms,Ultrasound guided ,Thrombin injection. |
