内镜下微量射频治疗难治性胃食管反流病疗效的meta分析  

Efficacy of endoscopic microradiofrequency in the treatment of refractory gastroesophageal reflux disease:a meta-analysis

作　　者：姜元喜[1] 陈莹[1] 孙会会[1] 许树长[1] Jiang Yuanxi;Chen Ying;Sun Huihui;Xu Shuchang(Department of Gastroenterology,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学附属同济医院消化科,上海200065

出　　处：《中华消化病与影像杂志（电子版）》2021年第6期280-285,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：上海市卫生健康委员会科研课题(202040079);上海申康医院发展中心市级医院新兴前沿技术联合攻关项目(SHDC12016109)。

摘　　要：目的对内镜下微量射频治疗难治性胃食管反流病(GERD)的疗效进行meta分析。方法通过计算机检索Medline、Embase、Cochrane Library、Elsevier、万方数据库、维普数据库及中国知网数据库,收集有关难治性GERD内镜下微量射频治疗疗效的文献,经纳入和排除标准筛选文献,提取入选文献的数据资料,采用RevMan 5.3软件进行meta分析。结果共纳入9篇文献,均为队列研究。Meta分析结果显示,内镜下微量射频治疗GERD可以明显降低患者烧心(平均差值-2.21,P<0.00001)、反流(平均差值-3.85,P<0.00001)、胸痛(平均差值-2.92,P<0.00001)、咳嗽(平均差值-3.87,P<0.00001)、哮喘(平均差值-4.15,P<0.00001)等症状评分,降低胃食管反流病相关生活质量量表(GERD-HRQL)评分(平均差值-19.84,P<0.00001),减少质子泵抑制剂(PPI)的使用(99.9%vs 41.2%,P<0.00001),减轻食管炎(62.3%vs 34.0%,P<0.00001)。治疗前后患者满意度评分有所提高(平均差值2.46,P<0.00001),但满意人数差异无统计学意义(20.0%vs87.9%,P=0.28)。结论内镜下微量射频治疗GERD可以明显缓解患者烧心、反流、胸痛、咳嗽、哮喘等症状,提高生活质量,减少PPI使用,减轻食管炎。Objective To determine the efficacy of the endoscopic microradiofrenquency in the treatment of patients with refractory gastroesophageal reflux disease(GERD) using meta-analysis.Methods Medline,Embase,Cochrane Library,Elsevier,Wanfang,VIP and CNKI were searched by computer to collect literatures on the efficacy of endoscopic microradiofrenquency for refractory GERD.The literatures were screened by inclusion and exclusion criteria,and the data of the selected literatures were extracted.Meta analysis was performed using RevMan 5.3 software.Results A total of 9 studies were enrolled,all of which were cohort studies.The meta-analysis results showed that endoscopic microradiofrenquency could reduce the heartburn(mean difference-2.21,P<0.000 01),regurgitation(mean difference-3.85,P<0.000 01),chest pain(mean difference-2.92,P<0.000 01),cough(mean difference-3.87,P<0.000 01) and asthma score(mean difference-4.15,P<0.000 01).The procedure also reduced GERD-health related quality of life(GERD-HRQL)score(mean difference-19.84,P<0.000 01),the use of proton pump inhibitor(PPI)(99.9% vs 41.2%,P<0.000 01)and esophageal inflammation(62.3% vs 34.0%,P<0.000 01).After treatment,the satisfaction score of patients were improved(mean difference 2.46,P<0.000 01),but the difference in the number of satisfied patients was not statistically significant(20.0% vs 87.9%,P=0.28).Conclusion Endoscopic microradiofrenquency can significantly relieve patients’ heartburn,regurgitation,chest pain,cough,asthma and other symptoms,improve the quality of life,reduce the use of PPI,and relieve esophageal inflammation.

关 键 词：META分析 内镜 射频 难治性胃食管反流病 

分 类 号：R571[医药卫生—消化系统]