结肠分管出血的内镜治疗方法:通过直接和网络元分析进行系统审查
Zahid Ijaz Tarar1, Mustafa Gandhi1, Faisal Inayat2
1Division of Gastroenterology and Hepatology, University of Missouri, Columbia, MO 65212, United States.
内镜可拆卸索带绑定 (EDSL) 显示在结肠分离出血 (CDB) 方面优于内镜剪切和内镜带绑定 (EBL). 在CDB患者中,EDSL可实现更好的初始血液静止,并显著降低晚期再出血率.
科学领域:
- 胃肠病学
- 内镜手术
- 治疗出血问题
背景情况:
- 结肠分管出血 (CDB) 是下胃肠道出血的主要原因之一.
- 内镜剪切,内镜带绑定 (EBL) 和内镜可拆卸索带绑定 (EDSL) 是CBD常见的血液静止方法.
- 对于这些内镜治疗方法的比较疗效数据仍然不一致.
研究的目的:
- 为了比较内镜剪切,EBL和EDSL用于管理CDB的有效性和并发症率.
- 评估三个内镜干预的初始血液静止和早期和晚期复出率.
主要方法:
- 在主要数据库 (PubMed/MEDLINE,Scopus,Web of Science,Embase,Google Scholar,Cochrane) 中进行系统的文献搜索.
- 包括关于CBD和内镜剪切,EBL或EDSL的临床试验.
- 计算初始血液静止,早期/晚期再出血和需要手术/栓塞的综合估计值.
主要成果:
- 分析了28项涉及4526名需要内镜干预的活性CBD患者的研究.
- 与EBL (10.7%) 和EDSL (10.6%) 相比,内镜切割显示出明显更高的早期复出率 (23.5%).
- 与切割 (27.2%) 和EBL (13.8%) 相比,EDSL表现出较优异的后期再出血率 (2.7%).
结论:
- 对于CDB的初始血液静止,内镜可拆解索带绑定 (EDSL) 比内镜剪切和EBL更有效.
- 在患有大肠分管出血的患者中,EDSL显著降低了晚出血率.
- 与剪切和绑定相比,陷技术为管理CDB提供了更好的结果.
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