摘要
目的系统评价聚桂醇改良"三明治"法治疗胃底静脉曲张的疗效及安全性。方法计算机检索The Cochrane Library、PubMed、EMbase、CNKI、维普和万方数据库, 检索时限为从建库至2020-06-30, 由2位研究者独立进行文献筛选, 然后对纳入的合格文献进行所需资料提取, 使用Revman 5.3软件对纳入文献的止血有效率, 术后发热、胸腹痛、局部溃疡、异位栓塞、总体不良反应发生率和术后再出血率各结局指标进行合并分析(Mantel-Haenszel法)。结果根据文献检索流程逐层筛选文献后最终有8项随机对照试验纳入Meta分析, 共有898例患者, 结果显示:与经典"三明治"法相比, 改良"三明治"法止血效果好(P=0.01, OR=2.07, 95%CI:1.17~3.68), 术后异位栓塞发生率低(P=0.001, OR=0.06, 95%CI:0.01~0.34), 在术后发热发生率(P=0.58, OR=0.86, 95%CI:0.52~1.44)、胸腹痛发生率(P=0.83, OR=0.95, 95%CI:0.58~1.56)、局部溃疡发生率(P=0.31, OR=0.66, 95%CI:0.30~1.47)、再出血率(P=0.14, OR=0.76, 95%CI:0.53~1.09)和不良反应总发生率(P=0.24, OR=0.66, 95%CI:0.33~1.32)方面差异均无统计学意义。结论改良"三明治"法治疗胃底静脉曲张效果明显且安全。
Objective To systematically evaluate the efficacy and safety of tissue adhesive combined with lauromacrogol(modified Sandwich method)for gastric varices.Methods Literature in the Cochrane Library,PubMed,EMbase,CNKI,VIP and Wanfang were searched by two independent researchers from the establishment of the databases to June 30,2020,and qualified data from the eligible literature were extracted.Revman 5.3 was used to analyze outcomes including hemostatic efficiency,incidence of postoperative fever,chest and abdominal pain,ulcer,ectopic embolism and complications,and postoperative re-bleeding rate(Mantel-Haenszel method).Results A total of 8 randomized controlled trials including 898 patients were included in this meta-analysis.The results showed that compared with the classic Sandwich method,the modified version had a better hemostatic effect(P=0.01,OR=2.07,95%CI:1.17-3.68)and a lower incidence of postoperative ectopic embolism(P=0.001,OR=0.06,95%CI:0.01-0.34).There were no significant differences in the incidences of postoperative fever(P=0.58,OR=0.86,95%CI:0.52-1.44),chest and abdominal pain(P=0.83,OR=0.95,95%CI:0.58-1.56),local ulcer(P=0.31,OR=0.66,95%CI:0.30-1.47),re-bleeding(P=0.14,OR=0.76,95%CI:0.53-1.09)or overall incidence of adverse reactions(P=0.24,OR=0.66,95%CI:0.33-1.32).Conclusion The modified Sandwich method of tissue adhesive combined with lauromacrogol is an effective and safe method in the treatment of gastric varices.
作者
张其良
刘应莉
王艳荣
杨倩
张秋瓒
Zhang Qiliang;Liu Yingli;Wang Yanrong;Yang Qian;Zhang Qiuzan(Department of Gastroenterology,Tianjin Fourth Center Hospital,Tianjin 300140,China)
出处
《中华消化内镜杂志》
CSCD
2022年第5期399-404,共6页
Chinese Journal of Digestive Endoscopy
关键词
食管和胃静脉曲张
三明治法
聚桂醇
Esophageal and gastric varices
Sandwich method
Lauromacrogol
