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《Chinese Journal of Difficult and Complicated Cases》 2017-03
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Meta-analysis of drug therapy and thoracic endovascular aortic repair for the treatment of acute uncomplicated B aortic dissection

HUANG Jizhen;WANG Zhiwei;HU Zhipeng;LI Bowen;WU Hongbing;HU Xiaoping;Department of Cardiovascular Surgery,Renmin Hospital of Wuhan University;  
Objective To objectively evaluate the hospital mortality(30 days mortality) and long term mortality for thoracic endovascular aortic repair(TEVAR) vs medical treatment in treating acute uncomplicated type B aortic dissection.Methods For this review,we searched PubMed,CENTRAL,EMbase,MEDUNE,Web of Science,CNKI,CBM,VIP and WanFang Data for clinical control trials until July 31,2016.Controlled control trials in which patients with acute uTBAD were assigned to TEVAR or medical treatment were included.The researchers were selected according to the inclusion and exclusion criteria for clinical controlled trials,and Cochrane Bias evaluation were used to evaluate the quality of the evidence and data extraction,to meet the quality standard of controlled clinical trials was used for meta-analysis by using Revman 5.2 software.Results Seven trials(5 644 participants) were included in this review.4 665 patients were involved in medical treatment group and 979 patients were involved in TEVAR group.Cochrane Bias evaluation reveals that all the seven studies were moderate bias risk.The results of meta analyses showed that;TEVAR vs.medical treatment,there was no significant differences in hospital mortality(OR =0.78,95%CI0.57-1.07,P =0.12);compared with medical treatment,the TEVAR group had lower total long term mortality rate(OR =0.31,95%CI0.21-0.45,P 0.01)and aortic related mortality(OR =0.24,95%CI 0.14-0.42,P 0.01).Conclusion Compared with drug therapy,TEVAR can not reduce the uncomplicated acute type B aortic dissection in hospital mortality,but TEVAR improve the long term mortality(including the aorta related death rate).
【Fund】: 国家自然科学基金资助项目(81570428)
【CateGory Index】: R654.3
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