Zhao Ling, Pang Yanlei, Zhang Huijing, Li Yong, Zheng Qun, Li Fengde
Department of Cardiology, the Fourth People's Hospital of Hengshui, NO.485 Xinhua Road.
Department of Cardiology, Hengshui People's Hospital, NO.180 Renmin Road, Taocheng District, Hengshui, Hebei, China.
Medicine (Baltimore). 2020 Nov 13;99(46):e23227. doi: 10.1097/MD.0000000000023227.
When atherosclerosis occurs in the coronary artery, resulting in stenosis, occlusion, or spasm of the coronary artery, the supply of blood and oxygen to the myocardium will be reduced or even unavailable, resulting in myocardial necrosis and heart pain, chest tightness, dyspnea and other symptoms caused by myocardial necrosis are collectively referred to as coronary atherosclerotic heart disease. Coronary angiography can not only understand the degree of coronary artery damage, but also estimate the prognosis of coronary artery stenting, which provides a reliable reference for clinical treatment. Transradial coronary angiography (TCA) has the advantages of high success rate, small trauma, less complications, no bed rest, reduce hospital stay and other superiority, which accepted and used by physicians. Although the success rate of surgery is high, the postoperative complications will still affect the effect of surgery and the prognosis of patients. The main manifestations are radial artery occlusion (RAO), forearm hematoma formation, pseudoaneurysm formation, periosteal compartment syndrome, radial artery perforation, etc. Among the many ways to prevent RAO, anticoagulant therapy with common heparin is one of them, but the dosage of heparin is not clear. Therefore, we decided to use systematic evaluation to evaluate the clinical effectiveness and safety of different dose of heparin in preventing of RAO, and to provide clinical basis for the early prevention and treatment of RAO.
Two reviewers independently searched PubMed, Embase, the Cochrance Library, Web of Science, Medline, CBM Disc, CNKI, and WANFANG Data to find the eligible research. The retrieval about the randomized controlled trials of different dose of heparin in preventing the occurrence of RAO after TCA in recent years. The retrieval time is set between January 1990 and June 2020. The retrieval language is Chinese/English. Two researchers independently searched, managed and screened the literature through the search terms. When the 2 parties have inconsistent opinions on the inclusion or not of certain literature, the literature will be referred to the third researcher for discussion and decision. The included studies are conducted bias risk assessment through bias risk assessment tool, which based on Cochrane Handbook 5.0. The extracted data uses RevMan5.3 software for statistical processing.
The research results of this systematic review will be published in peer-reviewed medical-related academic journals.
This study adopts the Meta-analysis method and expands the sample size, which will give high-quality evidence-based medicine evidence on the clinical effectiveness and safety of different dose of heparin in preventing the occurrence of RAO.
OSF, DOI 10.17605/OSF.IO/CPXJ3.
当冠状动脉发生动脉粥样硬化,导致冠状动脉狭窄、闭塞或痉挛时,心肌的血液和氧气供应将减少甚至无法供应,导致心肌坏死,心肌坏死引起的心痛、胸闷、呼吸困难等症状统称为冠状动脉粥样硬化性心脏病。冠状动脉造影不仅可以了解冠状动脉损伤程度,还可以评估冠状动脉支架置入术的预后,为临床治疗提供可靠参考。经桡动脉冠状动脉造影(TCA)具有成功率高、创伤小、并发症少、无需卧床、缩短住院时间等优势,被医生所接受和应用。尽管手术成功率高,但术后并发症仍会影响手术效果及患者预后。主要表现为桡动脉闭塞(RAO)、前臂血肿形成、假性动脉瘤形成、骨膜间隔综合征、桡动脉穿孔等。在预防RAO的多种方法中,普通肝素抗凝治疗是其中之一,但肝素的用量尚不明确。因此,我们决定采用系统评价来评估不同剂量肝素预防RAO的临床有效性和安全性,为RAO的早期防治提供临床依据。
两名评价员独立检索PubMed、Embase、Cochrance图书馆、Web of Science、Medline、CBM Disc、CNKI和万方数据,以查找符合条件的研究。检索近年来不同剂量肝素预防TCA术后RAO发生的随机对照试验。检索时间设定为1990年1月至2020年6月。检索语言为中文/英文。两名研究人员通过检索词独立检索、管理和筛选文献。当双方对某篇文献是否纳入存在不一致意见时,将该文献交由第三名研究人员讨论决定。纳入的研究通过基于Cochrane手册5.0的偏倚风险评估工具进行偏倚风险评估。提取的数据使用RevMan5.3软件进行统计处理。
本系统评价的研究结果将发表在同行评审的医学相关学术期刊上。
本研究采用Meta分析方法,扩大了样本量,将为不同剂量肝素预防RAO的临床有效性和安全性提供高质量的循证医学证据。
OSF,DOI 10.17605/OSF.IO/CPXJ3。