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目的 对比脉冲场消融（PFA）与冷冻球囊消融（CBA）治疗心房颤动的有效性和安全性。方法 搜索中国知网（CNKI）、万方数据库、PubMed、Cochrane Library、EMbase等电子数据库纳入符合要求的临床研究。应用RevMan5.4软件统计分析数据。结果 纳入15项研究，共4743例患者（PAF组1876例，CBA组2867例）。Meta分析结果显示，PFA相比CBA能提高急性肺静脉隔离成功率（OR=4.72,95%CI:2.36～9.45,P<0.001）；降低房性心律失常复发率（OR=0.82,95%CI:0.69～0.98,P=0.03）及总并发症发生率（OR=0.46,95%CI:0.32～0.67,P<0.001）；缩短手术时间（OR=-12.77,95%CI:-15.25～-10.29,P<0.001）；两组在透视时间方面无统计学差异（OR=1.44,95%CI:-1.01～3.89,P=0.25）。结论 相比冷冻球囊消融，心房颤动患者行脉冲场消融可提高急性肺静脉隔离成功率，降低房性心律失常复发率及总并发症发生率并缩短手术时间，需更多大样本高质量研究证实。
Abstract：Objective To compare the effectiveness and safety of pulsed field ablation(PFA) and cryoballoon ablation(CBA) in treatment of atrial fibrillation(AF). Methods Electronic databases such as China National Knowledge Infrastructure(CNKI), Wanfang Database, PubMed, Cochrane Library and EMbase were retrieved to include eligible clinical studies. RevMan 5.4 software was used for statistical analysis of the data. Results Fifteen studies were included, involving a total of 4743 patients [1876 cases in PFA group and 2867 cases in CBA group]. The results of Meta-analysis showed that, compared with CBA, PFA could increase the success rate of acute pulmonary vein isolation(OR=4.72, 95%CI:2.36～9.45, P<0.001), reduce the recurrence rate of atrial arrhythmia(OR=0.82, 95%CI:0.69～0.98, P=0.03) and the total incidence of complications(OR=0.46, 95%CI:0.32～0.67, P<0.001), and shorten the operation time(OR=-12.77, 95%CI:-15.25～-10.29, P<0.001). There was no statistically significant difference in fluoroscopy time between 2 groups(OR=1.44, 95%CI:-1.01～3.89, P=0.25). Conclusion Compared with CBA, PFA can elevate the success rate of acute pulmonary vein isolation, reduce the recurrence rate of atrial arrhythmia and total incidence of complications, and shorten the operation time, and the conclusion needs more studies with large sample and high quality to verification.
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基本信息:
中图分类号:R541.75
引用信息:
[1]黄志伟,张超,蔡小桃.脉冲场消融与冷冻球囊消融治疗心房颤动的Meta分析[J].中国循证心血管医学杂志,2025,17(12):1416-1421.
2025-12-20
2025-12-20