本文選題：套扎術(shù) + 氬氣刀凝固術(shù)��； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:內(nèi)鏡下套扎術(shù)是一種常用并且有效的治療食管曲張靜脈破裂出血的方法,但是有較高的食管曲張靜脈復(fù)發(fā)率。最近研究指出內(nèi)鏡下套扎術(shù)聯(lián)合氬氣刀凝固術(shù)(聯(lián)合治療組)對(duì)于預(yù)防食管曲張靜脈復(fù)發(fā)療效優(yōu)于單獨(dú)應(yīng)用內(nèi)鏡下套扎術(shù)(對(duì)照組)。系統(tǒng)評(píng)價(jià)套扎術(shù)聯(lián)合氬氣刀凝固術(shù)及套扎術(shù)二級(jí)預(yù)防食管曲張靜脈破裂出血的療效及安全性差異。方法:利用英文數(shù)據(jù)庫,根據(jù)制定的檢索關(guān)鍵詞檢索來源于Pub Med,Cochrane Library以及Science Direct的隨機(jī)對(duì)照臨床試驗(yàn)。分析比較聯(lián)合治療組及對(duì)照組的治療效果及不良反應(yīng)事件發(fā)生率。計(jì)算相應(yīng)結(jié)局指標(biāo)的相對(duì)危險(xiǎn)度(RR)、相對(duì)危險(xiǎn)差(RD)或標(biāo)準(zhǔn)化均差(SMD)。異質(zhì)性通過χ2及I2檢驗(yàn)。結(jié)果:總共4項(xiàng)隨機(jī)對(duì)照臨床試驗(yàn)納入本文,共230例患者。聯(lián)合治療組食管曲張靜脈復(fù)發(fā)率明顯低于對(duì)照組(RR=0.19,95%CI:0.09 0.41,P=0.000)。兩組的再出血率及死亡率并無顯著差別(分別為RR=0.29,95%CI:0.08 1.04,P=0.058及RD=-0.02,95%CI: 0.08 0.04,P=0.576)。聯(lián)合治療組發(fā)熱率明顯高于對(duì)照組(RR=3.42,95%CI:1.56 7.48,P=0.002),存在內(nèi)部異質(zhì)性(I~2=52.5%,P=0.097)。結(jié)論:套扎術(shù)聯(lián)合氬氣刀凝固術(shù)對(duì)于預(yù)防食管曲張靜脈復(fù)發(fā)療效優(yōu)于套扎術(shù)且沒有嚴(yán)重的不良反應(yīng)。但是需要更多高質(zhì)量的隨機(jī)對(duì)照臨床試驗(yàn)來進(jìn)一步證實(shí)。
[Abstract]:Objective: endoscopic ligation is a common and effective method for the treatment of esophageal varices bleeding, but there is a higher recurrence rate of esophageal varices. Recent studies have shown that endoscopic ligation combined with argon coagulation (combined treatment group) is more effective than endoscopic ligation alone in preventing esophageal variceal recurrence (control group). The efficacy and safety of ligation combined with argon coagulation and secondary ligation in preventing esophageal variceal bleeding were systematically evaluated. Methods: a randomized controlled clinical trial was conducted using the English database to retrieve the key words from Pub Medchrane Library and Science Direct. To compare the therapeutic effect and the incidence of adverse events between the combined treatment group and the control group. The relative risk of the corresponding outcome index was calculated by RRN, RD, or the standardized mean difference (SMDD). The heterogeneity was tested by 蠂 2 and I 2. Results: a total of 230 patients were enrolled in 4 randomized controlled clinical trials. The recurrence rate of esophageal varices in the combined treatment group was significantly lower than that in the control group. There was no significant difference in the rate of rebleeding and mortality between the two groups (RRR: 0.29 / 95 CI: 0.08 / 1.04U P0. 058 and RD- 0.02 / 95 CI: 0. 08 / 0.04 / P + 0. 576). The febrile rate in the combined treatment group was significantly higher than that in the control group. Conclusion: ligation combined with argon coagulation is superior to ligation in preventing esophageal variceal recurrence with no serious adverse reactions. But more high-quality randomized controlled clinical trials are needed to further confirm it.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R655.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Cong Dai;Wei-Xin Liu;Min Jiang;Ming-Jun Sun;;Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage:A meta-analysis[J];World Journal of Gastroenterology;2015年08期

2 Christos Triantos;Maria Kalafateli;;Endoscopic treatment of esophageal varices in patients with liver cirrhosis[J];World Journal of Gastroenterology;2014年36期

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本文編號(hào)：1799248