不同方法治疗贲门失弛症疗效差异性的系统评价

Therapeutic efficacy evaluation achalasia treated with differential strategies

目的评价不同方法治疗贲门失弛症的疗效。方法通过检索近10年Cochrane Library、Pubmed、Medline、WebofScience、万方数据库、维普中文科技期刊全文数据库、中国学术期刊全文数据库，对纳入研究的方法学进行评价。研究者对纳入文献的质量进行严格评价和资料提取，使用Review manager5．0软件对符合质量标准的随机对照试验（RCT）行系统评价。结果6个RCT共278例患者纳入研究，其中治疗组（使用Heller＋Dor术式）138例，对照组（内镜下注射肉毒杆菌、球囊扩张法）140例，两组患者均行常规对症支持治疗。系统评价结果表明：治疗组患者术后胃食管反流人数、术后1个月内吞咽困难次数、术后3个月内吞咽困难次数与对照组相比，差异具有统计学意义。结论Heller＋Dor术式可显著提升贲门失弛症的疗效。

Objective To evaluate the therapeutic efficacy of achalasia using Heller combined with Dor procedures. Methods We targeted references in data bank （Cochrane Library, Pubmed, Medline, Web of Science, CECDB, CQVIP, CNKI） in past 10 years. The Review Manager 5. 0 soft- ware was utilized for RCT-line systematic evaluation in searched references matching quality stand- ards. Results Totally 278 patients in 6 RCT-line systems were involved in this study, in which 138 cases were in treatment group （Heller combined with Dor procedure） and 140 cases were in control group （endoscopic assisted injection of botulinum toxin or balloon dilatation）. The general support management was conducted in both groups. Our systematic evaluation indicated that the number of patients with GERD and dysphagia frequency at 1st and 3rd month after surgery were significantly less than those in control group. Conclusion The Heller combined with Dor procedures can improve the therapeutic efficacy in patients with achalasia.