摘要
目的分析内镜下抗反流黏膜切除术(ARMS)对胃食管反流病疗效及安全性。方法计算机检索PubMed、Web of Science、EMbase、Cochrane Library和中国知网、中国生物医学文献、万方、维普数据库中有关内镜下抗反流黏膜切除术(ARMS)在胃食管反流病中的临床疗效的相关文献,检索年限为建库至2022年10月1日。通过纽卡斯尔-渥太华质量评估量表(NOS量表)对文献进行质量评价,采用RevMan 5.3软件及Stata软件对结局指标进行Meta分析。结果共纳入17个研究,共472例病患者进行分析,Meta分析结果显示,ARMS术后GERD-Q评分(SMD=2.76,95%CI=2.01~3.521)、DeMeester评分(SMD=3.73,95%CI=2.30~5.16,P<0.00001)、酸反流时间百分比(SMD=3.95,95%=1.94~5.96,P<0.00001)、手术时间为39.445 min(95%CI=29.52~49.37,P<0.00001,Z=7.79,P<0.05)、并发症发生率为0.08%(95%CI=0.06~0.12,P<0.00001,Z=5.76,P<0.05)。结论内镜下抗反流黏膜切除术(ARMS)对胃食管反流病的疗效及安全性值得肯定,但对于24 h酸反流持续时间较长的患者疗效一般,而对于酸反流时间占比小于10%的患者有显著疗效,以上结论还需要多中心、多病例进行验证。
Objective To analyze the efficacy and safety of endoscopic anti-reflux mucosal resection(ARMS)for gastroesophageal reflux disease.Methods PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,Chinese Biomedical Literature,Wanfang and VIP databases were searched for the clinical efficacy of endoscopic anti-reflux mucosal resection(ARMS)in gastroesophageal reflux disease.The retrieval period was from the establishment of the database to October 1,2022,and the quality of the literature was evaluated by Newcastle-Ottawa Quality Assessment Scale(NOS).RevMan 5.3 software and Stata software were used for meta-analysis of outcome indicators.Results A total of 472 cases were included in 17 studies.The results of meta-analysis were as follows:GERD-Q score(SMD=2.76,95%CI=2.01~3.52),DeMeester score(SMD=3.73,95%CI=2.30-5.16,P<0.00001),percentage of acid reflux time(SMD=3.95,95%CI=1.94-5.96,P<0.00001),operation time was 39.445 minutes(95%CI=29.52-49.37,P<0.00001,Z=7.79,P<0.05),complication rate was 0.08%(95%CI=0.06-0.12,P<0.00001,Z=5.76,P<0.05).Conclusion Endoscopic anti-reflux mucosal resection(ARMS)is effective and safe for gastroesophageal reflux disease.However,it is generally effective for patients with a long duration of 24 h acid reflux,and has a significant effect in patients with less than 10%acid reflux time.The above conclusion still needs to be verified by multi-center and multi-case study.
作者
自翔宇
张跃文
曹渊卿
刘红羽
ZI Xiang-yu;ZHANG Yue-wen;CAO Yuan-qing;LIU Hong-yu(The First Department of General Surgery,Yan'an Hospital,Kunming 650000,Yunnan,China)
出处
《医学信息》
2023年第20期83-88,共6页
Journal of Medical Information
基金
昆明市卫生健康委员会卫生科研课题项目(编号:20200401001)。
关键词
内镜
抗反流黏膜切除术
胃食管反流病
Endoscopy
Anti-reflux mucosal resection
Gastroesophageal reflux disease
