内镜下套扎术联合β受体阻滞剂预防肝硬化食管静脉曲张再出血的Meta分析.pdfVIP

窑临床研究 窑 中国医药导报 2015年 1月第 12卷第2期 内镜下套扎术联合 β-受体阻滞剂 预防肝硬化食管静脉曲张再出血的Meta分析 冯瑞兵 石家庄市第一医院消化二科袁河北石家庄 050011 [摘要] 目的评价食管静脉曲张套扎术渊EVL冤联合 茁-受体阻滞剂与单独套扎术对肝硬化食管静脉破裂再出血二 级预防的疗效遥 方法计算机检索Cochranelibrary尧Pubmed尧Ovid尧Embase袁中国生物医学文献数据库渊CBM冤及中 国期刊全文数据库渊CNKI冤袁检索时间从建库至2014年8月袁并辅以手工检索有关EVL和茁-受体阻滞剂预防食 管静脉曲张破裂再出血的随机对照临床试验渊RCT冤袁按Cochrane协作网推荐的方法袁采用Revman 5.2.5版软件 进行Meta分析遥 结果共纳入7篇文献袁共计600例患者袁其中试验组301例袁对照组299例遥 试验组使用EVL 联合 茁-受体阻滞剂治疗袁对照组单独使用EVL治疗遥 Meta分析结果显示袁试验组与对照组比较袁试验组可明显 降低肝硬化食管静脉曲张破裂再出血的发生率[OR =0.29袁95%CI渊0.16袁0.54冤袁P 约0.0001]曰随访期内两组总病死 率比较差异无统计学意义[OR =0.67袁95%CI院渊0.43袁1.06冤袁P=0.09]遥 同时袁再出血发生率及总病死率的漏斗图均 比较对称袁说明存在发生偏倚的可能性较小遥 结论EVL联合 茁-受体阻滞剂预防肝硬化食管静脉曲张再出血疗 效优于单独采用EVL治疗遥 [关键词] 肝硬化曰食管静脉曲张破裂再出血曰食管静脉曲张套扎术曰茁-受体阻滞剂曰Meta分析 [中图分类号] R575.2 [文献标识码]A [文章编号] 1673-7210渊2015冤01渊b冤-0074-05 Endoscopic variceal ligation with 茁-blockers for prevention of secondary varicealbleedingincirrhosis:aMeta-analysis FENG Ruibing The Second Department of Gastroenterology, the First Hospital of Shijiazhuang City, Hebei Province, Shijiazhuang 050011, China [Abstract]ObjectiveTo evaluatethe prophylactic efficacy of endoscopicvariceal ligation (EVL)with 茁-blockers and EVL alone in decreasing the rate of secondary esophageal variceal bleeding in patients with cirrhosis. Methods Cochrane library, Pubmed, Ovid, Embase, CMB and CNKI Database from database foundation to August 2014 were searchedby computer and the relatedjournals to identify randomized controlled trials (RCT) about EVL with 茁-block鄄 ersand EVL alone for prevention of secondary variceal bleeding in cirrhotic patients were searched by hand. Meta- analysis was conducted by using Revman 5.2.5 software recommended by the Cochrane Collaboration. Results Seven RCTs wer