目的：本研究旨在对比冷冻消融和射频消融治疗房室结折返性心动过速（AVNRT）的有效性和安全性。 方法：对Medline、The Cochrane Library、Embase数据库进行系统性检索，检索截止时间为2014-05，纳入满足选择标准的研究。 结果：最终5篇随机对照研究和14篇回顾性研究入选。研究总人群2900例，其中1384例分布在冷冻组，1516例分布在射频组。总体结果显示，与射频消融相比，尽管冷冻消融减少永久性房室传导阻滞（AVB）的风险（OR：0.27；95%CI 0.11~0.62，P<0.01）和X线透视时间（WMD：-3.36；95%CI-5.58~-1.15，P<0.01），但冷冻消融的即刻成功率略低（OR：0.63；95%CI 0.42~0.96，P<0.05），花费更长的手术时间（WMD：10.97；95%CI 3.35~18.58，P<0.01），而且复发率明显更高（OR：2.89；95%CI 2.05~4.06，P<0.01）。 结论：虽然冷冻消融治疗AVNRT减少房室阻滞的风险，但有效性低于射频消融。%Objective: The compare the safety and efficacy between cryoablation (CRYO) and radiofrequency catheter ablation (RFCA) for treating the patients with atrio-ventricular nodal reentrant tachycardia (AVNRT) by meta-analysis. Methods: We systemically searched the Medline, Cochrane library and Embase database to fulifll our pre-deifned criteria until the publication of May 2014. Results: There were 5 randomized controlled trials (RCTs) and 14 retrospective trials enrolled in our study with 2900 patients. The patients were allocated into 2 groups:CRYO group, n=1384 and RFCA group, n=1516. The overall pool-analysis demonstrated that compared with RFCA group, CRYO group had the lower risk of permanent atrio-ventricular nodal block (OR:0.27, 95%CI 0.11 to 0.62, P<0.01) and shorter X-ray exposure time (WMD:-3.36, 95%CI-5.58 to-1.15, P<0.01);while CRYO group had the lower immediate procedural success rate (OR:0.63, 95%CI 0.42 to 0.96, P<0.05), longer procedural time (WMD:10.97, 95%CI 3.35 to 18.58, P<0.01), and higher long-term arrhythmia recurrence rate (OR:2.89, 95%CI 2.05 to 4.06, P<0.01). Conclusion: Although CRYO could decrease the risk of permanent atrio-ventricular nodal block, while its effectiveness was lower than RFCA for AVNRT treatment in relevant patients.
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