内镜套扎与硬化剂预防肝硬化食管静脉曲张再出血Meta分析被引量：3

Endoscopic ligation and sclerotherapy for prevention of cirrhosisesophageal varices bleeding:a Meta-analysis

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摘要目的比较套扎与硬化注射对食管静脉曲张出血患者的疗效,评价两者在二级预防中的价值。方法检索Springer、Pubmed、Sinomed、CNKI、Cochrane Library,万方等数据库,用Cochrane图书馆的Rev Man5.1软件进行Meta分析。结果共纳入7项随机对照试验,结果显示,套扎治疗后再出血发生率显著低于硬化治疗（OR=0.54,95%CI：0.38~0.76,Z=3.56,P=0.000）;两者降低病死率方面相似（OR=0.79,95%CI：0.55~1.14,Z=1.27,P=0.21）;套扎组较硬化组能明显减少合并症（OR=0.22,95%CI：0.13~0.38,Z=5.51,P=0.000）;两组消除静脉曲张方面效果等同（OR=1.46,95%CI：0.98~2.18,Z=1.88,P=0.060）。漏斗图分析表明本研究对纳入文献评价的发表偏倚较小。结论套扎较硬化注射在食管静脉曲张出血二级预防中疗效更佳。 Objective To compare the efficacy of endoscopic variceal ligation （ EVL） with sclerotherapy （ EVS） for patients with esophageal variceal hemorrhage and evaluate the values of the two methods in the secondary prevention .Methods The related lit-erature was identified from Pubmed ,Medline,Embase,CNKI,the library of Cochrane and Wanfang database .RevMan 5.1 software pro-vided by the Library of Cochrane was used for Meta-analysis.Results A total of 7 randomized controlled trials were included .It was shown that the rehemorrhage rate of EVL was significantly lower than that of EVS （ OR =0.54 ,95%CI=0.38~0.76 ,Z=3.56 ,P =0.0004）.Meanwhile,there was no significant difference in mortality between EVL and EVS （OR=0.79,95%CI=0.55~1.14,Z=1.27 ,P =0.21 ） .Compared with EVS ,EVL could significantly reduce the complications of treatment （ OR=0.22 ,95%CI =0.13~0.38,Z=5.51,P =0.00001）.There was no significant difference in elimination of varicose veins between EVL and EVS （OR=1.46, 95%CI：0.98~2.18 ,Z=1.88 ,P =0.06 ） .The funnel plot analysis showed that bias for selected publications was small .Conclusion EVL is better than EVS in the prevention of rehemorrhage of esophageal varices .

作者周涛胡莲张华强罗永祥

机构地区四川省宜宾市第一人民医院消化内科

出处《实用医院临床杂志》 2016年第4期129-133,共5页 Practical Journal of Clinical Medicine

关键词食管静脉曲张出血二级预防硬化套扎 META分析 Esophageal varices bleeding Secondary prophylaxis Sclerotherapy Ligation Meta analysis

分类号 R571.3 [医药卫生—消化系统]

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