染色色体内镜优于高清白光内镜在炎症性肠道疾病患者的发育不良检测:随机对照试验的更新元分析
Mouhand F H Mohamed1, Daniel Marino1, Khaled Elfert2
1Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
The American journal of gastroenterology
|December 1, 2023
概括
与高清白光内镜 (HD-WLE) 相比,染料喷雾染色内镜 (DCE) 在炎症性肠病 (IBD) 患者的监测结肠镜中显著改善了失生症的检测. 当专业知识可用于高风险IBD监测时,建议使用DCE.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 在瘤学瘤学.
背景情况:
- 监测结肠镜对于检测炎症性肠病 (IBD) 患者的发育不良至关重要.
- 使用高清 (HD) 镜头的染料喷涂染色体 (DCE) 的附加值仍在争论中.
研究的目的:
- 为了比较DCE与HD白光内镜 (HD-WLE) 在IBD患者监测结肠镜检测缺血的疗效.
- 更新使用这些内镜技术检测发育不良症检测率的元分析.
主要方法:
- 系统地搜索随机对照试验 (RCT),比较IBD患者的HD-WLE和DCE.
- 使用随机效应模型检测出缺血性病变的患者比例的聚合分析.
- 使用推,评估,开发和评估 (GRADE) 方法对证据确定性的评估.
主要成果:
- 涉及978名患者的6项RCT显示,DCE检测出显著更多的患有发育不良的患者 (18.8%),而不是HD-WLE (9.4%) (OR 1.94,高CoE).
- 除了单个操作员的非劣势性试验之外的灵敏度分析减少了异质性,并显示出更强的效果 (OR 2.46).
- 高度发育不良的检测在数字上是DCE的更高,但在统计学上并不显著 (OR 2.21,低Coe).
结论:
- 在IBD患者中,DCE是检测IBD患者整体发育不良症的优越策略,即使有HD范围.
- 在有专业知识的情况下,应考虑在高风险IBD患者中对DCE进行监测.
- 需要进一步的试验来确认长期的结果,并评估虚拟染色内镜的作用.
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