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目的：系统评价采用体外循环与非体外循环下冠状动脉旁路移植术比较，治疗冠状动脉粥样硬化性心脏病的再血管化率。方法：计算机检索MEDLINE（1966～2010.3）、EMbase（1984～2010.3）、Cochrane 临床对照试验资料库（2010 年第2 期）和中国生物医学文献数据库（1979～2010.3），同时手工检索所有纳入试验的参考文献，质量评价后用RevMan 5.0 软件进行Meta 分析。结果：共纳入2 个随机对照试验，包括2276 例患者。Meta 分析结果显示：体外循环组的再血管化率高于单用非体外循环组，其差异有统计学意义P <0.00001[OR=1.78，95%CI（1.40，2.26）]。结论：当前的证据表明，体外循环下冠状动脉旁路移植术在治疗冠心病时，再血管化率比非体外循环高；评价患者长期预后有一定指导意义。由于纳入研究随访时间较短，上述结论尚需要高质量、大样本、长时间的随机双盲对照试验进一步证实。

英文摘要:

Objective: To evaluate the completeness of revascularization about off-pump versus on-pump coronary artery bypass in patients with coronary heart disease. Methods: Randomized controlled trials (RCTs) were identified from MEDLINE (1966 to March 2010), EMbase (1984 to March 2010), The Cochrane Library(issue2, 2010) and CBM-disc (1979 to March 2010). Data were extracted with designed criterion and evaluated with Cochrane Handbook for Systematic Reviews of Interventions 4.2.6 by two reviewers independently. The Cochrane Collaboration's RevMan 5.0 software was used for data analyses. Results: Two RCTs involving 2276 patients were included. Two studies showed that the completeness of revascularization in on-pump group was significantly higher than that in the off-pump group (P <0.00001) [OR = 1.78, 95% CI (1.40, 2.26)]. Conclusion: The current evidences indicated that the completeness of revascularization in on-pump group was higher than the off-pump group; which was useful to evaluate the long-term prognosis of patients .But the studies we inclued had a short follow-up time, More trials of high quality are required.

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