透明帽辅助内镜治疗食管异物疗效和安全性的系统评价与Meta分析  

Efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies:A systematic review and meta-analysis

作　　者：闵卫润 洪子强 崔百强 金大成 董信春 苟云久[2] MIN Weirun;HONG Ziqiang;CUI Baiqiang;JIN Dacheng;DONG Xinchun;GOU Yunju(First Clinical Medical School,Gansu University of Chinese Medicine,Lanzhou,730000,P.R.China;First Department of Thoracic Surgery,Gansu Provincial Hospital,Lanzhou,730000,P.R.China)

机构地区：[1]甘肃中医药大学第一临床医学院,兰州730000 [2]甘肃省人民医院胸外一科,兰州730000

出　　处：《中国胸心血管外科临床杂志》2024年第12期1846-1854,共9页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：甘肃省自然科学基金资助项目(20JR10RA388);兰州市城关区创新创业项目(2020RCCX0010)。

摘　　要：目的 系统评价透明帽辅助内镜(cap-assisted endoscopy,CAP辅助内镜)治疗食管异物的疗效及安全性。方法 计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、CNKI和万方数据库,从建库至2022年11月CAP辅助内镜和传统内镜治疗食管异物的相关文献。文献质量评价采用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)。Meta分析采用RevMan 5.4.1软件。结果 最终纳入27篇研究,包括17篇随机对照研究、2篇队列研究和8篇病例对照研究,共3 619例患者。NOS评分≥7分。Meta分析结果显示相比于传统内镜治疗,CAP辅助内镜组取出食管异物成功率更高[OR=14.43,95%CI(10.64,19.55),P<0.000 1],术后并发症更少[OR=0.30,95%CI(0.23,0.38),P<0.000 1],患者耐受度更好[OR=4.07,95%CI(2.95,5.60),P<0.000 1],术中视野清晰度更佳[OR=12.00,95%CI(7.29,19.76),P<0.000 1],手术时间更短[SMD=-1.83,95%CI(-2.31,-1.34),P<0.000 1]。结论 CAP辅助内镜治疗食管异物是一种有效且安全的方法,值得在临床上进一步推广和应用。Objective To systematically review the efficacy and safety of cap-assisted endoscopy in the treatment of esophageal foreign bodies.Methods PubMed,Web of Science,The Cochrane Library,EMbase,CNKI and Wanfang databases were searched by computer for relevant literatures on cap-assisted endoscopy and traditional endoscopy for esophageal foreign bodies from inception to November 2022.The quality assessment of the literature was conducted using the Newcastle-Ottawa Scale(NOS).Meta-analysis was performed using RevMan 5.4.1.ResultsFinally,27 studies were collected,including 17 randomized controlled trials,2 cohort studies and 8 case-control studies,with a total of 3619 patients.NOS scores of all studies were≥7 points.Meta-analysis results showed that compared with traditional endoscopic treatment,the success rate of removing esophageal foreign bodies in the cap-assisted endoscopy group was higher(OR=14.43,95%CI 10.64 to 19.55,P<0.0001),postoperative complications were fewer(OR=0.30,95%CI 0.23 to 0.38,P<0.0001),patients tolerance was better(OR=4.07,95%CI 2.95 to 5.60,P<0.0001),intraoperative visual field clarity was better(OR=12.00,95%CI 7.29 to 19.76,P<0.0001)and operative time was shorter(SMD=-1.83,95%CI-2.31 to-1.34,P<0.0001).Conclusion Cap-assisted endoscopy for esophageal foreign bodies is an effective and safe method,worthy of further promotion and application in clinical practice.

关 键 词：食管异物 透明帽辅助内镜 内镜治疗 系统评价/META分析 

分 类 号：R571[医药卫生—消化系统]