静脉动脉-体外膜肺氧合支持治疗暴发性心肌炎患者的临床结局：一项系统评价和Meta分析

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Clinical Outcomes of Venoarterial Extracorporeal Membrane Oxygenation Support in Patients with Fulminant Myocarditis ：A Systematic Review and Meta-Analysis

ZHONG Yumei，WU Jiani，QIU Zhengyuan，TANHuiyu （The Seventh Afliated Hospital，Sun Yat-sen University，Shenzhen 5181O7，Guangdong，China）

【Abstract】ObjectiveTosystematicallyevaluateandquantifytheclinicaloutcomesofvenoarterialextracorporealmembrane oxygenation（VA-ECMO）inpatientsithfulminantmyocarditis（FM）MethodsDomesticandinteratioaldatabasesweresysteaticaly searchedfrominceptiontoJanuary225forsingle-armstudiesreportingoutcomesofVA-ECOinFM.Literaturescrenngandquality assessmentwerepeformedacordingtopredefinedcriteria.Baselinecharacteristicsandmainendingwereextracted.Meta-analysiswas conducted using random-effect or fixed-effect models to calculate pooled effect sizes and 95%CI ，withsubgroup and sensitivity analyses. Heterogeneity was assessed byχ2 and I2 tests;publication bias was evaluated by inverted funnel plot，Egger's and Begg's tests.ResultsA totalof0higqualityomesticdinteatoalsudisereiuddasedonadomftsodelwitlitrasfoatforeta analysis，the pooled mortality rate of VA-ECMO in patientswithFM was 38 % （ 95%cl28%～48% ），with substantialheterogeneityamong studies（ I2=93%，P<0.001 ）.Subgroup analyses showed significant heterogeneity within each subgroup（ I2>80%，P<0.05） . There was no statistically significant difference in pooled mortality rates among different study countries （ P=0.621 ），while differences between treatment strategies，study designs，and study quality were statistically significant （ P<0，05 ）. Six studies reported weaning outcomes，including 312 patients.A random-effects model showed a pooled weaning success rate of 78%（95%CI65%～87% ），withhigh heterogeneity（ I2=90%X2= 48.920，P<0.001） .Both Egger’sand Begg's tests indicated no significant publication bias（ t=0.471 Z=1 .100，P>0.05）.Conclusion CurrentevieesuportstatVA-ansitlypoesrosinttraetof，sfde mortality rate and a higher weaning success rate.

【Keywords】Fulminantmyocarditis；Extracorporealmembraneoxygenation;Venoarterialextracorporealmembraneoxygenation; Mortality： Weaning success rate

暴发性心肌炎（fulminantmyocarditis，FM）是一种罕见且高致死率的急性心肌疾病，常伴血流动力学不稳定和多器官功能障碍」，初期死亡率为 27.0% ～60.0%[2] 。（剩余10165字）