普萘洛尔和经内镜硬化治疗预防肝硬化静脉曲张再出血的荟萃分析  

Propranolol and endoscopic sclerotherapy in the prevention of variceal rebleeding in patients with cirrhosis: a metaanalysis

作　　者：柴新 张英国 

机构地区：[1]甘肃省武威肿瘤医院,甘肃省武威市733000

出　　处：《世界华人消化杂志》2010年第1期94-99,共6页World Chinese Journal of Digestology

摘　　要：目的:系统评价普萘洛尔和经内镜硬化疗法预防肝硬化静脉曲张再出血的有效性和安全性.方法:计算机检索PubMed、EMBASE、CochraneLibrary、CBM、CNKI、VIP数据库2009-02前发表的有关普萘洛尔和经内镜硬化疗法预防肝硬化静脉曲张再出血的随机对照试验,2名评价员独立对纳入文献进行质量评价和数据提取,用RevMan5.0软件统计分析.结果:共纳入9篇随机对照试验共计740例患者,Meta分析结果显示:两组在生存率(RR=0.97,95%CI:0.86-1.10)、病死率(RR=1.20,95%CI:0.90-1.59)方面差异均无统计学意义;普萘洛尔组再出血率高于经内镜硬化治疗组(RR=1.33,95%CI:1.14-1.54),但普萘洛尔组不良反应发生率低(RR=0.48,95%CI:0.26-0.86).结论:普萘洛尔与经内镜硬化治疗在预防再出血,再出血发生率高但不良反应发生率低.AIM： To systematically review the efficacy of propranolol and endoscopic sclerotherapy in the prevention of variceal rebleeding in patients with cirrhosis. METHODS： The PubMed database, Embase, the Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure （CNKI） database, and VIP database were searched for randomized controlled trials comparing the efficacy of propranolol and endoscopic sclerotherapy in the prevention of variceal rebleeding in patients with cirrhosis. Two reviewers independently evaluated the quality of included articles and extracted the data. Statistical analysis was performed using the Review Manager 5.0. RESULTS： Nine randomized controlled trials involving 740 patients were included. The result of meta-analysis showed that there was no significant difference between propranolol and endoscopic sclerotherapy in survival rate （RR = 0.97, 95%CI： 0.86-1.10） and case fatality （RR = 1.20, 95%CI： 0.90-1.59）. Propranolol-treated cirrhosis patients had higher rebleeding rate （RR = 1.33, 95%CI： 1.14-1.54）, but lower incidence of adverse events compared with those undergoing sclerotherapy （RR = 0.48, 95%CI： 0.26-0.86）. CONCLUSION： Propranolol-treated cirrhosis patients have higher rebleeding rate but lower incidence of adverse events compared with those undergoing endoscopic sclerotherapy.

关 键 词：普萘洛尔 内镜硬化治疗 肝硬化 静脉曲张 荟萃分析 

分 类 号：R575.2[医药卫生—消化系统]