在急性结肠伪阻塞中结肠镜解压的结果:系统性审查和元分析
Suprabhat Giri1, Veeraraghavan Krishnamurthy2, Devank Shah3
1Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India.
结肠镜解压是一种安全有效的治疗急性结肠伪阻塞 (ACPO),成功率超过90%,穿孔风险低于1%. 这种方法在ACPO管理中比新兴药成功率高.
科学领域:
- 胃肠病学
- 大肠直肠手术
- 内镜检查程序
背景情况:
- 急性结肠伪阻塞 (ACPO) 呈现为没有机械或外部炎症原因的结肠阻塞.
- 建议在ACPO病例中进行结肠减压,这些病例对保守和医疗治疗没有反应.
研究的目的:
- 系统地审查和分析急性结肠伪阻塞的结肠镜解压效果和安全性.
- 为了比较结肠镜解压的成功率与neostigmine.
主要方法:
- 在MEDLINE,EMBASE和Scopus数据库中进行了全面的文献搜索.
- 在ACPO中,包括的研究报告了临床成功,穿孔,复发,以及在结肠镜解压后需要手术.
- 采用随机效应逆变率模型来组合研究比例.
主要成果:
- 第一次结肠镜减压后的成功率为78. 8%,整体成功率为91. 5%.
- 结肠镜解压的成功率明显高于neostigmine的成功率 (OR 3. 85).
- 整体穿孔发生率为0. 9%,复发率为17. 1%,整体外科手术发生率为10. 5%,成功解压后发生率为3. 7%.
结论:
- 对ACPO的结肠镜解压显示出高的疗效和安全性.
- 这种手术的临床成功率超过90%,穿孔率低于1%.
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