粘膜缺陷的预防性关闭与内镜切除后延迟不良事件之间的关联:系统性审查和元分析
Shaoxiong Yi1,2, Qinbo Cai3, Lele Zhang3
1Digestive Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.
BMJ open
|October 18, 2024
概括
在内镜切除后预防性关闭粘膜缺陷可显著降低延迟出血和穿孔风险. 然而,这项技术并没有显著影响预防多聚斑瘤后凝血综合征.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 医疗干预 医疗干预
背景情况:
- 胃肠道 (GI) 病变的内镜切除可以导致粘膜缺陷.
- 延迟出血和穿孔等不良事件是潜在的并发症.
- 作为预防措施,正在探索预防性关闭这些缺陷.
研究的目的:
- 评估粘膜缺陷的预防性关闭在预防内镜切除后不良事件的有效性.
- 分析关闭对延迟出血,延迟穿孔和多囊术后凝血综合征 (PPCS) 的影响.
主要方法:
- 对2022年2月之前发表的研究进行系统审查和元分析.
- 搜索了主要的数据库:PubMed,Embase,科学网和科克兰图书馆.
- 使用随机效应模型和子组分析,比较关闭和非关闭组之间的结果.
主要成果:
- 对28项涉及11,383名患者的研究进行了分析.
- 预防性关闭显著降低了延迟出血 (RR: 0.40,95% CI: 0.30-0.53) 和延迟穿孔 (RR: 0.42,95% CI: 0.22-0.82) 的发生率.
- 在关闭和非关闭组之间的PPCS发生率中没有发现显著差异.
结论:
- 预防性关闭粘膜缺陷是一种有效的策略,可以降低内镜切除后延迟出血和穿孔的风险.
- 关闭的好处并不延伸到减少PPCS的发生率.
- 进一步的研究可能会探索可以实现PPCS减少的特定场景.
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