摘要
目的 :对内镜下结扎及硬化联合术 (EVLS)治疗食管静脉曲张的研究进行系统评价。方法 :检索 1990年1月～ 2 0 0 0年 12月期间发表的有关内镜下结扎及硬化联合治疗食管静脉曲张的随机对照临床试验。按照入选标准 ,有 15项临床试验纳入本研究 ,由 2名作者各自独立地对入选研究中有关试验设计、研究对象的特征、研究结果等内容进行摘录 ,并用RevMan 3.1软件进行分析。结果 :EVLS组与EVL组对食管静脉曲张疗效的比较结果显示 :食管静脉曲张治疗无效的合并优势比 (OR)为 0 .2 9[95 %CI 0 .18,0 .4 7],P <0 .0 5 ;而食管静脉曲张复发及上消化道出血的合并OR分别为 0 .6 9[95 %CI 0 .4 5 ,1.0 6 ],0 .76 [95 %CI0 .5 1,1.13],P >0 .0 5。EVLS组与EVS组对食管静脉曲张疗效的比较结果显示 :食管静脉曲张复发和上消化道出血的合并分别为3.37[95 %CI 1.4 5 ,7.80 ],0 .2 0 [95 %CI 0 .10 ,0 .39],P <0 .0 5 ;而食管静脉曲张治疗无效的合并OR为 0 .6 8[95 %C10 .38,1.2 2 ],P >0 .0 5。EVLS并发症的发生率较EVS为低 (2 5 .81%vs 77.5 5 % ,P <0 .0 1) ;但较EVL为高 (40 .98%vs 2 0 .0 8% ,P <0 .0 1)。结论 :EVLS对食管静脉曲张的治疗效果尚需进一步的验证 ,它并不能替代EVS或EVL作为治疗食管静脉曲张的首选方法。
Objective:To examine if endoscopic variceal ligation plus sclerotherapy was a more effective and safer method for esophageal varices. Methods:MEDLINE and China Biological Medicine Disk were searched for randomized controlled trials of combined ligation and sclerotherapy for esophageal varices from January 1990 to November 2000. According to included criteria, we choosed 15 studies at last. Two authors drew details about trial design, characters of participants, results and so on from including studies independently. Data was analysed by Revman3.1 software.Results:Comparison between EVLS and EVL after endoscopic treatment: the pooled OR of treatment failure,recurrence of EV,and upper gastrointestinal bleeding was 0.29 [95%CI 0.18, 0.47], P <0.05; the pooled OR of recurrence of EV, and upper gastrointestinal bleeding were 0.69 [95%CI 0.45, 1.06], 0.76 [95%CI 0.51, 1.13], P >0.05. Comparison between EVLS and EVL after endoscopic treatment: the pooled OR of recurrence of EV, and upper gastrointestinal bleeding were 3.37 [95%CI 1.45, 7.80], 0.20 [95%CI 0.10, 0.39], P <0.05; the pooled OR of treatment failure was 0.68 [95%CI 0.38, 1.22], P >0.05. The complication rate was lower in the EVLS group than in the EVS group (25.81% vs 77.55%, P <0.01), but was higher than in the EVL group (40.98% vs 20.08%, P <0.01).Conclusion:EVLS can not be the first treatment method of EV instead of EVS or EVL.
出处
《中国内镜杂志》
CSCD
2002年第9期33-36,共4页
China Journal of Endoscopy
