摘要
背景钛夹辅助内镜下组织胶注射治疗胃静脉曲张(gastric varices,GV)是一种新的和简单的技术,但由于缺乏可靠的数据,其在GV治疗中的疗效尚未清楚.目的本文运用Meta分析评价钛夹辅助内镜下组织胶注射治疗GV的疗效.方法检索国内外主要数据库中钛夹辅助内镜下组织胶注射vs内镜下直接组织胶注射治疗GV的研究.主要终点是评估两者之间的再出血性和有效性,次要终点是评价死亡和异位栓塞的发生.结果本Meta共纳入16项回顾性研究,一共1700人,其中报道有分流709(42%)人,钛夹组793人.钛夹组再出血(OR=0.26,95%CI:0.19-0.35,P<0.001)和死亡的发生降低(OR=0.50,95%CI:0.27-0.92,P<0.05),有效性高(OR=3.14,95%CI:2.13-4.63,P<0.001);两组异位栓塞的发生(OR=0.57,95%CI:0.18-1.80,P>0.05)无差异性.结论钛夹辅助内镜下组织胶注射是GV伴/不伴分流的一种简单、安全有效的技术.进一步充分有力的随机对照实验需确认这些结果.
BACKGROUND Clip-assisted endoscopic cyanoacrylate injection is a new and simple technique for the treatment of gastric varices(GV).However,due to the lack of reliable evidence,its efficacy is unclear.AIM To investigate the effi cacy of clip-assisted endoscopic cyanoa-crylate injection for the treatment of GV by a Meta-analysis.METHODS A comprehensive search of several databases was conducted to identify studies evaluating clip-assisted endoscopic cyanoacrylate injection vs conventional endoscopic cyanoacry-late injection in the treatment of GV.The primary endpoints were rebleeding and efficacy,and the secondary endpoints were the occurrence of death and ectopic embolization.RESULTS Sixteen retrospective studies involving 1700 patients were included in this Meta-analysis.There were 709 patients(42%)with shunt,and the clip-assisted group had 793 patients.The rates of rebleeding(odds ratio[OR]=0.26,95%confidence interval[CI]:0.19-0.35,P<0.001)and death(OR=0.50,95%CI:0.27-0.92,P<0.05)were significantly lower,and the efficacy(OR=3.14,95%CI:2.13-4.63,P<0.001)was significantly better in the clip-assisted group.There was no difference in ectopic embolization(OR=0.57,95%CI:0.18-1.80,P>0.05)between the two groups.CONCLUSION Clip-assisted endoscopic cyanoacrylate injection is a simple and effective technique for the treatment of GV with/without shunt.Adequately powered randomized clinical trials are warranted to confirm the findings of this study.
作者
吕永才
姚燕华
雷静静
Yong-Cai Lv;Yan-Hua Yao;Jing-Jing Lei(Department of Gastroenterology,Zhenning Buyi and Miao Autonomous County People’s Hospital,Anshun 561200,Guizhou Province,China;Department of Ultrasound,Zhenning Buyi and Miao Autonomous County Traditional Chinese Hospital,Anshun 561200,Guizhou Province,China;Department of Geriatric Medicine,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)
出处
《世界华人消化杂志》
CAS
2024年第2期158-165,共8页
World Chinese Journal of Digestology
