结扎和硬化疗法治疗肝硬化食管静脉曲张出血疗效比较的荟粹分析

目的:对套扎疗法与硬化疗法治疗肝硬化食管静脉曲张出血的疗效进行系统评价．方法:通过Medline、EMBase和中国期刊全文数据库检索1985-01／2005-11发表的有关硬化疗法与套扎疗法治疗肝硬化食管静脉曲张出血相关文献,并采用RevMan4．2．8进行Meta分析．结果:按照入选标准,有7项前瞻性随机对照临床试验纳入．Meta分析结果显示,硬化疗法在治疗肝硬化食管静脉曲张中的再出血率高于套扎疗法(RR=1．32,95％CI:1．10-1．57, P<0．05);而在降低死亡率方面二者相似(RR= 1．24,95％CI:0．99-1．55,P>0．05)．结论:套扎疗法较硬化疗法在治疗肝硬化食管静脉曲张中能更好的预防再出血,在降低死亡率方面无差异．

Comparison between effects of ligation and sclerotherapy in treatment of esophageal variceal bleeding after liver cirrhosis: a meta-analysis

AIM: To systematically evaluate the therapeutic effect of endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) on esophageal variceal bleeding after liver cirrhosis. METHODS: The correlated literature about the therapeutic effect of EIS and EVL on esophageal variceal were identified from Medline, EMBase and China Biological Medicine Disk between January, 1985 and November, 2005. RevMan 4.2.8 software was used for data analysis. RESULTS: According to the included criteria,seven prospective, randomized, controlled, clinical trials were selected finally. The combined results of meta-analysis showed that the rehaemorrhage rate of scherotherapy on the esophageal variceal bleeding after liver cirrhosis was higher than ligation (RR = 1.32, 95%CI: 1.10-1.57, P < 0.05), while their motility rates were similar (RR = 1.24,95%CI: 0.99-1.55, P > 0.05). CONCLUSION: In comparing with EIS, EVL has a better effect on obviating rehaemorrhage in esophageal varices bleeding after liver cirrhosis but has no difference in degrading motility.