文献类型：期刊文献

中文题名：腋静脉通路植入心脏电子设备有效性和安全性的meta分析

英文题名：Efficacy and safety of axillary vein access for cardiac electronic device implantation:a meta-analysis

作者：蒋均仕[1];赵小鹏[1];贾成文[1];纪召娟[1];宋昱军[1];崔换弟[2]

第一作者：蒋均仕

机构：[1]甘肃中医药大学附属医院心血管科,甘肃兰州730000;[2]甘肃省人民医院超声医学科,甘肃兰州730099

第一机构：甘肃中医药大学第二附属医院

年份：2025

卷号：34

期号：3

起止页码：394

中文期刊名：实用心电与临床诊疗

外文期刊名：PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

基金：甘肃省自然科学基金资助项目(21JR7RA584)。

语种：中文

中文关键词：腋静脉;心脏植入式电子设备;随机对照试验;meta分析

外文关键词：axillary vein;cardiac implantable electronic device;randomized controlled trial;meta-analysis

摘要：目的通过meta分析探讨经腋静脉通路植入心脏电子设备的有效性及安全性。方法检索中国知网、Embase、中国生物医学文献数据库、PubMed、万方数据库、Cochrane图书馆中相关文献,检索时间范围从各数据库建立之初至2024年12月,共检索到604篇关于腋静脉通路植入心脏电子设备的随机对照研究。通过Cochrane协作网提供的偏倚风险评估工具对所纳入的文献进行质量评价,然后提取数据,采用I2和Cochran-Q检验完成异质性检验,运用RevMan 5.4软件进行数据统计分析。结果最终纳入13篇文献,共2341例患者。Meta分析结果显示,与对照组相比,腋静脉组穿刺成功率相对更高(RR=1.07,95%CI 1.01~1.13,P=0.020),穿刺时间明显缩短(MD=-2.13,95%CI-3.01~-1.24,P<0.01);腋静脉途径手术操作时间更短(MD=-9.86,95%CI-11.70~-8.02,P<0.01),并发症数量更少(RR=0.66,95%CI 0.50~0.87,P=0.003)。结论腋静脉通路植入心脏电子设备成功率高、耗时短、不良反应少,可作为首选的穿刺途径,但仍需要更大样本、更科学合理的前瞻性随机对照研究来验证。
Objective To explore the efficacy and safety of cardiac electronic device implantation via the axillary vein access by meta-analysis.Methods We searched related literature from CNKI,Embase,CBM,PubMed,WanFang and Cochrane Library database,setting the searching time from the establishment of each database until December 2024.A total of 604 randomized controlled studies on the implantation of cardiac electronic devices through the axillary vein access were retrieved.We evaluated the quality of the enrolled literature by means of the bias risk assessment instrument provided by the Cochrane Collaboration,and then extracted the data and completed heterogeneity test using I2 and Cochran-Q tests.Data were statistically analyzed using RevMan 5.4 software.Results A total of 13 studies involving 2341 patients were ultimately included.The results of meta-analysis showed that compared with the control group,the success rate of puncture in the axillary vein group was relatively higher{RR=1.07,95%CI[1.01,1.13],P=0.020},with significantly shorter puncture time{MD=-2.13,95%CI[-3.01,-1.24],P<0.01}.The operation time of the axillary vein approach was shorter{MD=-9.86,95%CI[-11.70,-8.02],P<0.01},and the complications were fewer[RR=0.66,95%CI(0.50,0.87),P=0.003].Conclusion The cardiac electronic device implantation via axillary vein access demonstrates a high success rate,short operation time and low incidence of adverse events,which enables it as a preferred puncture approach.However,more scientifically reasonable prospective randomized controlled studies with larger sample sizes are still needed to make it verified.