透明帽辅助内镜下取出食管异物疗效的Meta分析

目的评价透明帽辅助内镜下取出食管异物的临床价值。方法通过计算机检索Pubmed、CNKI数据库、Web of Knowledge、Cochrane图书馆对照试验注册库和万方数据库从建库至2017年的有关透明帽辅助内镜取出食管异物的相关文献,采用Cochrane协作网提供的RevMan 5.0版软件进行统计处理,对纳入资料的异质性进行分析,计算OR值和95%可信区间。结果按照入选标准,纳入了9项临床试验,共1 103例患者。Meta分析结果显示:透明帽辅助内镜异物取出术成功率更高(OR=8.58,95%CI:4.49～16.38,P 0.05)、视野更清晰(OR=7.35,95%CI:5.20～10.40,P 0.05)、并发症发生率低(OR=0.34,95%CI:0.25～0.46,P 0.05)、患者耐受性好(OR=2.78,95%CI:2.08～3.72,P 0.05)。结论透明帽辅助内镜下食管异物取出术是一种安全有效的内镜下取异物的方法,其患者耐受性好,可提供更好的内镜下操作视野,有利于提高手术成功率,值得进一步推广应用。

Esophageal foreign body removed by transparent cap-assisted endoscope : a meta-analysis

Abstract: Objective To evaluate the clinical value of esophageal foreign body removed by transparent cap-assisted endoscope.Methods The literature on transparent cap-assisted endoscopic esophageal foreign body removal was retrieved combined with manual retrieval from Pubmed, China National Knowledge Infrastructure (CNKI), Web of Knowledge, the Cochrane controlled trials register library repository, Wanfang Database published between inception and 2017 in China. RevMan 5.0 software from Cochrane cooperation network was used for data analysis. Pooled odds ratio (OR) and 95%confidence intervals (95%CI) were calculated and the heterogeneity was also assessed.Results According to the selection criteria, 9 clinical trials with 1103 were selected finally. The combined results of meta-analysis showed that compared with traditional method, transparent cap-assisted endoscopic technique had higher success rate (OR=8.58, 95%CI: 4.49~16.38, P<0.05), better endoscopic vision clarity (OR=7.35, 95%CI: 5.20~10.40, P<0.05), low complication rate (OR=0.34, 95%CI: 0.25~0.46, P<0.05), good tolerance(OR=2.78, 95%CI: 2.08~3.72, P<0.05).Conclusion The study indicates that transparent cap-assisted endoscopic technique for body removal is safety, efficacy and good tolerance, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal. It suggest that this technique is worthy of wider clinical application.