腋静脉通路植人心脏电子设备有效性和安全性的meta分析

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[中图分类号]R541.7[文献标志码]A[文章编号]2097-5716（2025）03-0394-06

DOI： 10.13308/j.issn.2097-5716.2025.03.016

[引用格式」蒋均仕，赵小鹏，贾成文，等.腋静脉通路植入心脏电子设备有效性和安全性的meta分析[J].实用心电与临床诊疗，2025，34（3）：394-399，403.

Efficacy and safety of axillry vein access for cardiac electronic device implantation： a meta-analysis JIANG Junshi'，ZHAO Xiaopeng'，JIA Chengwen’，JI Zhaojuan’，SONG Yujun'，CUI Huandi²（1. Department of Cardiovascular Medicine，Afliated Hospital of Gansu Universityof Chinese Medicine，Lanzhou Gansu 730000; 2. Department of Ultrasound Medicine，Gansu Provincial People's Hospital，Lanzhou Gansu 730099，China）

[Abstract]ObjectiveTo explore the eficacy and safety of cardiac electronic device implantation via the axilary vein access by meta-analysis.MethodsWe searched related literature from CNKI，Embase，CBM， PubMed，WanFang and Cochrane Library database，seting the searching time from the establishment of each databaseuntil December 2O24.Atotalof 604 randomizedcontrolled studies ontheimplantation 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.ResultsA total of 13 studies involving 2341 patients were ultimately included.Theresultsof metaanalysis 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= （204号 -2.13， 95%CI [-3.01，-1.24]， P<0.01} . The operation time of the axillary vein approach was shorter {MD= （20 -9.86， ， P<0.01} ，and the complications were fewer[ RR=0.66 ， 95%CI （0.50， 0.87）， P=0.003 ]. ConclusionThe 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.

Key Words]axilary vein；cardiac implantable electronic device；randomized controlled trial；meta-analysis

随着预期寿命延长和人口老龄化加剧，心脏植人式电子设备（cardiac implantable electronic device，CIED）的植人数量逐年增长[]。（剩余7548字）