奥曲肽与硬化疗法治疗肝硬化食管静脉曲张出血的meta分析

发布时间：2018-11-22 20:00

【摘要】：目的:系统评价奥曲肽与硬化疗法治疗肝硬化食管静脉曲张出血的疗效。方法:计算机检索Pubmed数据库（1966--2013.12）、 Embase数据库（1974--2013.12）、Cochrane图书馆对照试验的中心资料库（2013.12）、万方数据库（1998--2013.12）、相关期刊论文（CNKI，，1979--2013.12）。收集奥曲肽与硬化疗法治疗肝硬化食管静脉曲张出血的随机对照试验（RCT）。用Cochrane图书馆的RevMan5.2软件进行meta分析。结果:共纳入8篇文献，包括1078例患者，奥曲肽组（试验组）540例，硬化疗法组（对照组）538例，其中A级文献3篇，B级文献5篇。meta分析结果显示，奥曲肽组治疗食管静脉曲张出血在早期止血率、再出血率（疗程内）、再出血率（42日内）、病死率（疗程内）、病死率（42日内）、不良反应发生率方面与硬化疗法组相比无统计学差异。合并优势比（OR）分别为1.20（95%CI为0.83~1.73，P=0.33）；1.16（95%CI为0.74~1.83，P=0.52）；0.80（95%CI为0.58~1.10，P=0.17）；1.15（95%CI为0.66~2.00，P=0.61）；1.11（95%CI为0.76~1.62，P=0.59）；0.46（95%CI为0.13~1.55，P=0.21）。采用RevMan5.2软件绘制倒漏斗图，除了再出血率（42日内）其余所有结果显示图形基本对称，提示文献发表偏倚可能性小。将每个研究逐一排除后的meta分析显示汇总灵敏度和特异度未见明显改变，说明纳入文献的稳定性好。结论:奥曲肽组和硬化疗法组治疗肝硬化食管静脉曲张出血，在早期止血率、再出血率、病死率及不良反应发生率方面并无统计学差异。在治疗肝硬化食管静脉曲张出血方面，硬化疗法并不优于奥曲肽治疗。
[Abstract]:Objective: to evaluate the efficacy of octreotide and sclerotherapy in the treatment of esophageal variceal hemorrhage due to cirrhosis. Methods: the Pubmed database (1966-2013.12), Embase database) (1974-2013.12), Cochrane library control database (2013.12), Wanfang database (1998-2013.12) was searched by computer. Full text Database of Chinese Journals (CNKI,1979--2013.12). Collection of octreotide and sclerotherapy in the treatment of cirrhosis esophageal variceal hemorrhage: a randomized controlled trial (RCT). Meta analysis is carried out with RevMan5.2 software of Cochrane library. Results: a total of 8 articles were included, including 1078 patients, 540 octreotide group (trial group) and 538 sclerotherapy group (control group), including 3 A literature and 5 B literature. The results of meta analysis showed that. In octreotide group, the early hemostasis rate, rebleeding rate (within course of treatment), rebleeding rate (within 42 days), death rate (within course of treatment), mortality rate (within 42 days) in the treatment of esophageal variceal bleeding were observed. There was no significant difference in the incidence of adverse reactions between the sclerotherapy group and the sclerotherapy group. The combined odds ratio (OR) was 1.20 (95%CI: 0.83C 1.73P 0.33), 1.16 (95%CI = 0.74 1.83P 0.52), 0.80 (95%CI = 0.58C 1.10P 0.17). 1.15 (95%CI: 0.662.00); 1.11 (95%CI: 0.761.62); 0.46 (95%CI: 0.131.55); 1.11 (95%CI: 0.761.62); 0.46 (95%CI: 0.131.55; 0.21). Using RevMan5.2 software to draw the inverted funnel graph, all the results except the rate of rebleeding (within 42 days) showed that the graph was basically symmetrical, indicating that the possibility of publication bias was small. The meta analysis, which excluded each study one by one, showed no significant change in aggregate sensitivity and specificity, which indicated that the stability of the literature included was good. Conclusion: there is no significant difference in early hemostasis rate, rebleeding rate, mortality and adverse reaction rate between octreotide group and sclerotherapy group in the treatment of cirrhosis esophageal variceal bleeding. Sclerotherapy is not superior to octreotide in the treatment of esophageal variceal bleeding due to cirrhosis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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