Effect of international normalized ratio self-management intervention on the complication of patients after mechanical heart valve replacement: a meta-analysis / 中国实用护理杂志

ABSTRACT

Objective To evaluate the influence of international normlized ratio(INR) self-management intervention on the complication of patients after mechanical heart valve replacement (MHVR).Methods The randomized controlled trials (RCT) about comparing the INR self-management with conventional management in patients after MHVR were researched by the database of PubMed, Medline, China Biomedical Literature Database, Wanfang data, Chinese National Knowledge Infrastructure, and the data were analyzed by Stata 12.0 software.Results Nine RCTs were enrolled in this study, 4 265 cases in total.The results of Meta-analysis showed that INR self-management could reduce the incidence of thrombosis, relative risk(RR) was 0.68, 95％ confidence interval (95％CI) was 0.50-0.94, P＜0.05.However, there was no significant difference in hemorrhage between the two groups, yet could not evaluate the effect on INR values within the target range, RR(95％CI) was 1.29(1.20-1.38), P＜0.05.But due to the high heterogeneity in literature, the results were for reference only, it remained to be further argumen.Conclusions INR self-management can reduce the incidence of thrombosis in patients after mechanical heart valve replacement, and does not increase the risk of bleeding complication at the same time.