在内镜下粘膜切割后预防食道狭窄的药理疗法:系统性审查和网络元分析
Yuxin Ma1, Liang Zhu2, Shutao Chen2
1The Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
International journal of surgery (London, England)
|January 14, 2026
概括
口服用酸凝和皮酸糖酸盐有效地防止内镜下粘膜解剖 (ESD) 后食道狭窄. 聚甘氨酸 (PGA) 片加上纤维素剂可最大限度地减少内透镜气球扩张疗程,用于狭窄管理.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 最少侵入性的手术
背景情况:
- 内镜下粘膜切割 (ESD) 是早期食道瘤的关键治疗方法.
- 手术后食道狭窄是ESD后的一个常见且具有挑战性的并发症.
- 减轻这种并发症的最佳药理策略需要进一步阐明.
研究的目的:
- 系统地比较药理干预措施在ESD后预防食道收缩的疗效.
- 确定最有效的治疗方案,以减少狭窄的发生率和内镜气球扩张 (EBD) 的需要.
主要方法:
- 在主要数据库 (Cochrane,Embase,PubMed,Web of Science) 进行了全面的系统文献搜索,截至2025年3月.
- 对31项涉及3085名接受ESD治疗的患者的研究进行了网络元分析.
- 评估的结果包括食道狭窄发生率和EBD会话的数量,使用随机效应模型分析并根据SUCRA值进行排名.
主要成果:
- 与标准护理相比,口服皮松酸盐酸盐与酸凝相结合显著降低了收缩风险 (RR=0.075,SUCRA=95.21%).
- 聚甘氨酸 (PGA) 片加上纤维素的组合在减少需要的EBD会话数量方面最有效 (MD=-6.4,SUCRA=95.82%).
结论:
- 口服皮酸和酸凝是预防ESD后食道狭窄的高度有效的药理方法.
- 使用带有纤维素的PGA片是最大限度地减少ESD后内镜气球扩张疗程的最佳策略.
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