保守治疗联合水溶性造影剂用于粘连性小肠梗阻有效性的Meta分析

目的:系统评价保守治疗联合水溶性造影剂用于粘连性小肠梗阻的有效性,为该疾病的临床用药提供循证参考.方法:计算机检索Cochrane图书馆、PubMed、Embase、万方数据库、中国知网,检索时限为各数据库自建库起至2020年9月.收集在保守治疗的基础上联合水溶性造影剂用于粘连性小肠梗阻有效性的随机对照试验(RCT),...

Therapeutic Efficacy of Conservative Treatment Combined with Water-soluble Contrast Agents for Adhesive Small Bowel Obstruction:A Meta-analysis

OBJECTIVE:To systematically evaluate the therapeutic effects of conservative treatment combined with water-soluble contrast agents for adhesive small bowel obstruction,and to provide evidence-based reference for clinical medication.METHODS:Retrieved from Cochrane library,PubMed,Embase,Wanfang database and CNKI during the inception to Sept.2020,RCTs about conservative treatment combined with water-soluble contrast agents in the therapeutic efficacy for adhesive small bowel obstruction were collected.After literature screening and data extraction,the quality of included literatures were evaluated with Cochrane system evaluator manual 5.1.0 and Jadad scale.Meta-analysis was conducted by using Rev Man 5.3 and Stata 16 software.RESULTS:A total of 15 RCTs were included,with 1429 patients in total.Results of Meta-analysis showed that the use of water-soluble contrast agents significantly reduced the surgical needs of patients with adhesive small bowel obstruction[OR=0.64,95%CI(0.50,0.81),P<0.001];reduced the remission time of non-surgical patients[MD=-23.37,95%CI(-32.17,-14.57),P<0.001],hospital stay days of non-surgical patients[MD=-2.21,95%CI(-2.52,-1.90),P<0.001]and hospital stay days of all patients[MD=-2.43,95%CI(-3.93,-0.92),P=0.002],and would not increase the incidence of complications[OR=1.15,95%CI(0.63,2.10),P=0.65],but could not reduce mortality[OR=1.26,95%CI(0.94,3.24),P=0.63]or the probability of bowel resection[OR=0.93,95%CI(0.57,1.52),P=0.78].CONCLUSIONS:The combined use of water-soluble contrast agents for patients with adhesive small bowel obstruction is safe and effective,can reduce the patient’s surgical requirements,and is beneficial to reduce the length of hospital stay and time for symptom relief.