内镜下氩离子凝固术联合质子泵抑制剂治疗Barrett食管效果的系统评价  

Effects of Combining Therapy of Argon Plasma Coagulation and Proton Pump Inhibitor on Barrett＇s Esophagus： A Systematic Review

作　　者：伍威[1] 邹金艳[1] 商建[1] 易三凤[1] 林军[1] 

机构地区：[1]武汉大学中南医院消化内科,湖北武汉430071

出　　处：《医学新知》2013年第5期330-335,共6页New Medicine

摘　　要：目的系统评价内镜下氩离子凝固术联合质子泵抑制剂治疗Barrett食管的效果。方法采用计算机检索与手工检索相结合的方法搜索CochraneDatabaseofSystematicReviews、MEDLINE、Embase、PEDro、OpenSIGLE、NationalTechnicalInformationService（NTIS）、CNKI、VIP、万方数据库和CBM中关于内镜下氩离子凝固术（argonplasmacoagulation，APC）联合质子泵抑制剂（protonpumpinhibitor，PPI）治疗Barrett食管的随机对照试验（RCT），检索时间从建库起至2012年12月1日。对纳入研究的质量进行评价，并进行资料提取，使用RevMan5软件对符合纳入标准的研究进行Meta分析。结果共纳入10项研究，包括324例APC联合PPI治疗，396例常规PPI治疗。结果表明，APC联合PPI治疗与PPI治疗相比，治疗后12个月的复发率的差异有统计学意义[OR=0．33，95％cI（0．12，0．88），P〈0．05]，随访3个月[OR=68．56，95％CI（10．25，458．46），P〈0．05、6个月IOR=66．45，95％CI（7．78，567．56），P〈0．051、12个月lOR=31．54，95％CI（7．82，127．10），P〈0．05]的总有效率的差异有统计学意义。结论APC联合PPI治疗Barrett食管可以降低短期（1年）复发率，目无严重并发症。Objective To evaluate the effects of argon plasma coagulation combined with proton pump inhibitor on Barrett~ esophagus. Methods Cochrane Database of Systematic Reviews, MEDLINE, Embase, PEDro, OpenSI- GLE, National Technical Information Service（NTIS） , CNKI, VIP, Wanfang Data and CBM were searched till Dec. 1, 2012. Randomized controlled trials （RCTs）of treatment effects of argon plasma coagulation （APC）combined with pro- ton pump inhibitor（PPI） on Barrettg esophagus were collected. Included studies were evaluated by GRADE. RevMan 5 software was used to analyze all the included studies. Results 10 studies were reviewed including 324 cases treated with APC combined with PPI and 396 cases treated with conventional PPI. There were significant differences in recur- rence rate after 12 month [ OR = 0.33,95% CI （ 0. 12,0.88 ）, P 〈 0.05 ], total effective rate after follow - up of 3 month [OR = 68.56,95% CI（10.25,458.46） ,P 〈 0.05] ,6 month [OR = 66.45,95% CI（7.78,567.56） ,P 〈 0.051, and 12 month [ 0R = 31.54,95 % CI （ 7.82,127.10 ）, P 〈 0.05 ] between the two therapies. Conclusion Combining therapy of APC and PPI on Barrettg esophagus can reduce recurrence rate in short term（ about 1 year）with no severe complications.

关 键 词：氩离子凝固术 质子泵抑制剂 BARRETT食管 随机对照试验 系统评价 Meta分析 

分 类 号：R571[医药卫生—消化系统]