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目的系统评价组织胶联合聚桂醇治疗胃底静脉曲张的疗效和安全性。方法计算机检索The Cochrane Library、Pub Med、EMbase、MEDLINE、CNKI、VIP和Wan Fang Data数据库,检索时限均为从建库至2016年10月31日,纳入有关组织胶联合聚桂醇治疗胃底静脉曲张的文献。由两名评价员按照文献的纳入与排除标准独立筛选文献、提取资料并进行文献质量评价,采用Cochrane官网提供的Rev Man 5.3软件进行Meta分析。结果共纳入5篇文献,614例患者。Meta分析结果显示,与单用组织胶组相比,组织胶联合聚桂醇组总有效率高(OR=2.18,95%CI1.44~3.31,P=0.000 2)、术后再出血率低(OR=0.63,95%CI 0.42~0.97,P=0.03)、术后胃底静脉曲张缓解时间短(MD=-2.56,95%CI-3.97~-1.14,P=0.000 4)及术后胃底静脉曲张消失时间短(MD=-2.33,95%CI-3.84~-0.82,P=0.002)快,但两组在止血效果、术后再出血时间及不良反应发生率方面差异无统计学意义(P>0.05)。结论组织胶联合聚桂醇在治疗胃底静脉曲张的疗效优于单用组织胶,但上述结论仍有待更多高质量的文献予以验证。
Objective To systematically evaluate the efficacy and safety of the combination of glue and lauromacyl alcohol in the treatment of gastric varices. Methods The databases of The Cochrane Library, Pub Med, EMbase, MEDLINE, CNKI, VIP and Wan Fang Data were searched by computer. The retrieval time was from the database to October 31, 2016, Qu Zhang literature. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the literature. Meta-analysis was performed using Rev Man 5.3 software provided by the Cochrane website. Results A total of 5 articles were included in 614 patients. The results of Meta analysis showed that the total effective rate of tissue glue combined with lauromacrolol group was higher (OR = 2.18,95% CI 1.44-3.31, P = 0.0002), and the rate of postoperative rebleeding was lower (OR = 0.63, 95% CI 0.42-0.97, P = 0.03), postoperative varices time was shorter (MD = -2.56,95% CI-3.97-1.14, P = 0.0004) The disappearance of varicose veins was shorter (MD = -2.33, 95% CI-3.84-0.82, P = 0.002), but there was no significant difference between the two groups in terms of hemostatic effect, postoperative bleeding time and the incidence of adverse reactions (P> 0.05). Conclusion Tissue glue combined with lauromacrogol in the treatment of gastric varices is superior to single tissue glue, but the above conclusion still needs more high-quality literature to be verified.