非变形上胃肠道出血的超范围剪辑:随机研究的系统综述和元分析
Yuanzhi Ni1,2, Kamran Ali3, Penghao Tang4
1Department of Hepatobiliary Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University, Shulan International Medical College, Dongxin Road. No. 848, Gongshu District, 310000, Hangzhou, Zhejiang, China.
与标准治疗相比,超范围剪贴 (OTSC) 显著改善初始血液静止,并减少与标准治疗相比,非静脉上部胃肠道出血 (NVUGIB) 患者的再出血,死亡率相似.
科学领域:
- 胃肠病学 胃肠病学
- 进行内镜干预.
- 医疗器械技术 医疗器械技术
背景情况:
- 非静脉上部胃肠道出血 (NVUGIB) 是一种常见的,危及生命的疾病.
- 对NVUGIB的标准内镜治疗 (ST) 有不一致的成功率.
- 超范围剪贴 (OTSC) 为NVUGIB管理提供了一个有前途的替代方案.
研究的目的:
- 为了比较OTSCs与ST对NVUGIB的疗效和安全性.
- 分析初始血液静止,持续出血和复出血率.
- 评估OTSC和ST之间的死亡率和住院差异.
主要方法:
- 在PubMed,Embase,Scopus和Cochrane图书馆数据库中进行全面的文献搜索.
- 包括六项随机对照试验 (RCT),涉及621名患者.
- 使用随机/固定的效应模型进行元分析,以计算聚合赔率比率 (OR) 和置信区间 (CI).
主要成果:
- 与ST相比,OTSC实现了显著更高的初始血液静止 (OR 4.80) 和更低的持续出血率 (OR 0.17).
- 在OTSC中,7天 (OR 0.27) 和30天 (OR 0.40) 的复出率显著降低.
- 在OTSC和ST组之间,在死亡率 (OR0.65) 或住院期间没有发现显著差异.
结论:
- 在NVUGIB中,OTSC在实现血液静止和防止再出血方面比ST更有效.
- 与标准治疗相比,OTSCs不会增加死亡风险.
- 结果支持OTSC作为NVUGIB的首选干预措施,可能会影响临床指南.
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