经口内镜下贲门缩窄术治疗胃食管反流病疗效的meta分析  

Efficacy of Peroral Endoscopic Cardial Constriction for Gastroesophageal Reflux Disease:A Meta⁃analysis

作　　者：马永芬[1] 赵磊 曹京梅[1] MA Yongfen;ZHAO Lei;CAO Jingmei(Department of Gastroenterology,Eastern Campus,Zibo Central Hospital,Zibo,Shandong Province,255020)

机构地区：[1]山东省淄博市中心医院东院消化内科,255020

出　　处：《胃肠病学》2024年第7期396-401,共6页Chinese Journal of Gastroenterology

摘　　要：背景:胃食管反流病(GERD)是我国最常见的疾病之一,消耗了大量医疗资源。经口内镜下贲门缩窄术(PECC)是新型内镜下治疗GERD的技术,其疗效和安全性仍在探索中。目的:探讨PECC治疗GERD的疗效和安全性。方法:检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Cochrane Library等数据库,收集有关PECC治疗GERD的文献,检索时间均为建库至2023年12月31日。按照纳入和排除标准筛选文献并提取数据。采用纽卡斯尔-渥太华量表(NOS)评分对文献质量进行评估,应用RevMan 5.3软件行meta分析。结果:共纳入11篇文献、265例GERD患者,平均随访时间为4个月。Meta分析结果显示,GERD患者PECC术后DeMeester评分(SMD=3.00,95%CI:2.02~3.98,P<0.00001)、酸暴露时间(AET)百分比(SMD=1.32,95%CI:1.02~1.63,P<0.00001)和胃食管反流病问卷(GerdQ)评分(SMD=3.17,95%CI:1.91~4.43,P<0.00001)均较术前显著降低,而下食管括约肌压力(LESP)显著升高(SMD=-4.50,95%CI:-7.45~-1.55,P=0.003)。所有PECC均顺利完成,无严重并发症发生。结论:PECC治疗GERD的短期疗效肯定,安全性较高。长期疗效有待后续研究进一步证实。Background:Gastroesophageal reflux disease(GERD)is one of the most prevalent diseases in China,consuming substantial medical resources.Peroral endoscopic cardial constriction(PECC)represents a novel endoscopic technique for the treatment of GERD,yet its efficacy and safety are still under exploration.Aims:To explore the efficacy and safety of PECC for GERD.Methods:Literatures regarding PECC in the treatment of GERD were retrieved from CNKI,Wanfang data,VIP,China Biology Medicine disc,PubMed,Embase and Cochrane Library.The retrieval time span was from the establishment of each database to December 31,2023.Literatures were enrolled according to the inclusion and exclusion criteria,and the data were extracted.Newcastle-Ottawa scale(NOS)score was used to evaluate the quality of literature.Metaanalysis was conducted by RevMan 5.3 software.Results:A total of 11 literatures involving 265 patients with GERD were enrolled.The mean follow-up time was 4 months.Meta-analysis showed that the DeMeester score(SMD=3.00,95%CI:2.02-3.98,P<0.00001),acid exposure time(AET)percentile(SMD=1.32,95%CI:1.02-1.63,P<0.00001)and gastroesophageal reflux disease questionnaire(GerdQ)score(SMD=3.17,95%CI:1.91-4.43,P<0.00001)in GERD patients were significantly decreased after PECC,while the lower esophageal sphincter pressure(LESP)was significantly increased(SMD=-4.50,95%CI:-7.45--1.55,P=0.003).All PECC procedures were completed successfully without serious complications.Conclusions:The short-term efficacy of PECC in the treatment of GERD is affirmative,and it demonstrates relatively high safety.However,its long-term efficacy needs to be further verified by subsequent research.

关 键 词：胃食管反流病 经口内镜下贲门缩窄术 治疗 安全 

分 类 号：R57[医药卫生—消化系统]