套扎术联合氩气刀凝固术与套扎术预防食管曲张静脉复发的荟萃分析

发布时间：2018-04-25 02:03

本文选题：套扎术 + 氩气刀凝固术　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:内镜下套扎术是一种常用并且有效的治疗食管曲张静脉破裂出血的方法,但是有较高的食管曲张静脉复发率。最近研究指出内镜下套扎术联合氩气刀凝固术(联合治疗组)对于预防食管曲张静脉复发疗效优于单独应用内镜下套扎术(对照组)。系统评价套扎术联合氩气刀凝固术及套扎术二级预防食管曲张静脉破裂出血的疗效及安全性差异。方法:利用英文数据库,根据制定的检索关键词检索来源于Pub Med,Cochrane Library以及Science Direct的随机对照临床试验。分析比较联合治疗组及对照组的治疗效果及不良反应事件发生率。计算相应结局指标的相对危险度(RR)、相对危险差(RD)或标准化均差(SMD)。异质性通过χ2及I2检验。结果:总共4项随机对照临床试验纳入本文,共230例患者。联合治疗组食管曲张静脉复发率明显低于对照组(RR=0.19,95%CI:0.09 0.41,P=0.000)。两组的再出血率及死亡率并无显著差别(分别为RR=0.29,95%CI:0.08 1.04,P=0.058及RD=-0.02,95%CI: 0.08 0.04,P=0.576)。联合治疗组发热率明显高于对照组(RR=3.42,95%CI:1.56 7.48,P=0.002),存在内部异质性(I~2=52.5%,P=0.097)。结论:套扎术联合氩气刀凝固术对于预防食管曲张静脉复发疗效优于套扎术且没有严重的不良反应。但是需要更多高质量的随机对照临床试验来进一步证实。
[Abstract]:Objective: endoscopic ligation is a common and effective method for the treatment of esophageal varices bleeding, but there is a higher recurrence rate of esophageal varices. Recent studies have shown that endoscopic ligation combined with argon coagulation (combined treatment group) is more effective than endoscopic ligation alone in preventing esophageal variceal recurrence (control group). The efficacy and safety of ligation combined with argon coagulation and secondary ligation in preventing esophageal variceal bleeding were systematically evaluated. Methods: a randomized controlled clinical trial was conducted using the English database to retrieve the key words from Pub Medchrane Library and Science Direct. To compare the therapeutic effect and the incidence of adverse events between the combined treatment group and the control group. The relative risk of the corresponding outcome index was calculated by RRN, RD, or the standardized mean difference (SMDD). The heterogeneity was tested by 蠂 2 and I 2. Results: a total of 230 patients were enrolled in 4 randomized controlled clinical trials. The recurrence rate of esophageal varices in the combined treatment group was significantly lower than that in the control group. There was no significant difference in the rate of rebleeding and mortality between the two groups (RRR: 0.29 / 95 CI: 0.08 / 1.04U P0. 058 and RD- 0.02 / 95 CI: 0. 08 / 0.04 / P + 0. 576). The febrile rate in the combined treatment group was significantly higher than that in the control group. Conclusion: ligation combined with argon coagulation is superior to ligation in preventing esophageal variceal recurrence with no serious adverse reactions. But more high-quality randomized controlled clinical trials are needed to further confirm it.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R655.4

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