套扎联合生长抑素治疗食管静脉曲张破裂出血疗效的Meta分析  

Effect of endoscopic variceal ligation combined with somatostatin in treatment of esophagealvariceal bleeding: a Meta-analysis

作　　者：申昊[1] 邓念[1] 钟立[1] 苟菊花 张秉强[1] 

机构地区：[1]重庆医科大学附属第一医院消化内科,重庆400016

出　　处：《胃肠病学和肝病学杂志》2015年第10期1205-1210,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：重庆市自然科学基金(CSTC;2011BB5123)

摘　　要：目的了解套扎联合生长抑素（somatostatin,SS）治疗食管静脉曲张（esophageal varices,EV）破裂出血的疗效。方法检索Pub Med、Embase、万方数据、CNKI、维普中文科技期刊等数据库中的文献,按照纳入和排除标准筛选文献。用Revman 5.0对急诊止血效果和预防近期再出血的疗效进行分析。结果最终纳入文献10篇,急诊止血方面共纳入7项研究,Meta分析结果显示,套扎联合SS对肝硬化EV破裂出血的疗效优于单纯套扎组,合并OR=3.59,95%CI：1.97~6.55（P〈0.0001）。预防近期再出血方面共纳入9项研究,Meta分析结果显示I2=71%,提示有不可忽略的异质性,考虑SS使用时间为异质性主要来源,遂在剔除未在套扎后使用SS或使用SS情况不明确的3项研究后再次行Meta分析,结果显示合并OR=4.07,95%CI：2.32~7.12（P〈0.00001）。结论套扎联合使用SS可以有效治疗肝硬化EV破裂出血,套扎术后使用2~5 d SS对于预防近期再出血有明显疗效。Objective To evaluate the efficacy of endoscopic variceal ligation（ EVL） combined with somatostatin（ SS） on the rate of first esophageal variceal（ EV） bleeding and the prevention of rehaemorrhagia in patients with cirrhosis. Methods Pub Med,Embase,Wan Fang Date,CNKI,Chongqing VIP Information Co.,etc were searched for studies about EVL plus SS on the rate of first EV bleeding and the prevention of rehaemorrhagia in patients with cirrhosis.Studies were screened according to the criteria of inclusion and exclusion. Revman 5. 0 was used to perform the statistical analysis. Results Ten articles were entered into this Meta-analysis. There were seven trials focus on the efficacy of EVL with SS on the rate of first EV bleeding. Summary OR of Meta-analysis was 3. 59,95% CI was 1. 97 ~ 6. 55（ P〈0. 0001）,the efficacy of EVL with SS on the rate of first EV bleeding had obvious advantages compared with only use EVL. Nine trials focused on the prevention of rehaemorrhagia in EV patients with cirrhosis. Because of the heterogenicity,the Meta-analysis after eliminated three trials which were not used SS or not described how to use the SS clearly,the summary OR was 4. 07,95% CI was 2. 32 ~ 7. 12（ P〈0. 00001）. Conclusion The treatment of EVL combined with SS for liver cirrhosis with EV bleeding is more effective than only EVL. Besides,the SS for 2 ~ 5 days after the EVL could prevent the rehaemorrhagia effectively.

关 键 词：肝硬化 食管静脉曲张破裂出血 食管静脉曲张套扎术 生长抑素 META分析 

分 类 号：R571.3[医药卫生—消化系统]