[The application effect of traditional monitoring and self-monitoring methods in oral anticoagulant patients with mechanical valve replacement patients: a meta-analysis].

Objective: To evaluate the effects of traditional monitoring and self-monitoring in patients who take the oral anticoagulation medicine after mechanical valve replacement surgical operations. Methods: A great number of Chinese and English literatures about this subject were investigated in detail, and these literatures were selected from the Cochrane Central Register of Controlled Trials, EMBase, MEDLINE, Web of Knowledge, CNKI, CBM, VIP, and WanFang Data. It should be noted that all of the literatures were published before October, 2015. Based on the results of the literature investigation, several studies were selected as the candidates. Moreover, many aspects about these candidates such as the experimental designs, characteristics of the objects of the studies and the results of the studies were filtered and recorded by two researchers independently. Furthermore, RevMan 5.3 were employed to analyze the data of the candidates. Results: Eight randomized controlled trials were studied, which included 1 262 cases in self-monitoring group and 1 198 cases in traditional monitoring group. The results of meta-analysis indicated that compared with the traditional monitoring group, lower incidence of thromboembolism (Z=3.50, P=0.000) and lower mortality (Z=4.64, P=0.000) were observed, and the bleeding difference (Z=0.07, P=0.940) had no significant statistical meaning. Moreover, compared with the traditional monitoring, the international normalized ratio (INR) of the patients who were controlled in the range of treatment of the self-monitoring increased from 6% to 20.9%, and the total number of the INR tests was increased by 2.1 to 4.98 times. Conclusions: Self-monitoring could obviously reduce the possibilities of the thromboembolism and death of the patients who took the oral anticoagulation medicine after mechanical valve replacement surgical operations. Furthermore, self-monitoring could not only control the INR in the range of treatment but also increase the total number of the INR tests. In short, self-monitoring has practical value of clinical application.