【摘要】：目的:系統(tǒng)評(píng)價(jià)奧曲肽與硬化療法治療肝硬化食管靜脈曲張出血的療效。 方法:計(jì)算機(jī)檢索Pubmed數(shù)據(jù)庫(kù)（1966--2013.12）、 Embase數(shù)據(jù)庫(kù)（1974--2013.12）、Cochrane圖書(shū)館對(duì)照試驗(yàn)的中心資料庫(kù)（2013.12）、萬(wàn)方數(shù)據(jù)庫(kù)（1998--2013.12）、相關(guān)期刊論文（CNKI，，1979--2013.12）。收集奧曲肽與硬化療法治療肝硬化食管靜脈曲張出血的隨機(jī)對(duì)照試驗(yàn)（RCT）。用Cochrane圖書(shū)館的RevMan5.2軟件進(jìn)行meta分析。 結(jié)果:共納入8篇文獻(xiàn)，包括1078例患者，奧曲肽組（試驗(yàn)組）540例，硬化療法組（對(duì)照組）538例，其中A級(jí)文獻(xiàn)3篇，B級(jí)文獻(xiàn)5篇。meta分析結(jié)果顯示，奧曲肽組治療食管靜脈曲張出血在早期止血率、再出血率（療程內(nèi)）、再出血率（42日內(nèi)）、病死率（療程內(nèi)）、病死率（42日內(nèi)）、不良反應(yīng)發(fā)生率方面與硬化療法組相比無(wú)統(tǒng)計(jì)學(xué)差異。合并優(yōu)勢(shì)比（OR）分別為1.20（95%CI為0.83~1.73，P=0.33）；1.16（95%CI為0.74~1.83，P=0.52）；0.80（95%CI為0.58~1.10，P=0.17）；1.15（95%CI為0.66~2.00，P=0.61）；1.11（95%CI為0.76~1.62，P=0.59）；0.46（95%CI為0.13~1.55，P=0.21）。采用RevMan5.2軟件繪制倒漏斗圖，除了再出血率（42日內(nèi)）其余所有結(jié)果顯示圖形基本對(duì)稱(chēng)，提示文獻(xiàn)發(fā)表偏倚可能性小。將每個(gè)研究逐一排除后的meta分析顯示匯總靈敏度和特異度未見(jiàn)明顯改變，說(shuō)明納入文獻(xiàn)的穩(wěn)定性好。 結(jié)論:奧曲肽組和硬化療法組治療肝硬化食管靜脈曲張出血，在早期止血率、再出血率、病死率及不良反應(yīng)發(fā)生率方面并無(wú)統(tǒng)計(jì)學(xué)差異。在治療肝硬化食管靜脈曲張出血方面，硬化療法并不優(yōu)于奧曲肽治療。
[Abstract]:Objective: to evaluate the efficacy of octreotide and sclerotherapy in the treatment of esophageal variceal hemorrhage due to cirrhosis. Methods: the Pubmed database (1966-2013.12), Embase database) (1974-2013.12), Cochrane library control database (2013.12), Wanfang database (1998-2013.12) was searched by computer. Full text Database of Chinese Journals (CNKI,1979--2013.12). Collection of octreotide and sclerotherapy in the treatment of cirrhosis esophageal variceal hemorrhage: a randomized controlled trial (RCT). Meta analysis is carried out with RevMan5.2 software of Cochrane library. Results: a total of 8 articles were included, including 1078 patients, 540 octreotide group (trial group) and 538 sclerotherapy group (control group), including 3 A literature and 5 B literature. The results of meta analysis showed that. In octreotide group, the early hemostasis rate, rebleeding rate (within course of treatment), rebleeding rate (within 42 days), death rate (within course of treatment), mortality rate (within 42 days) in the treatment of esophageal variceal bleeding were observed. There was no significant difference in the incidence of adverse reactions between the sclerotherapy group and the sclerotherapy group. The combined odds ratio (OR) was 1.20 (95%CI: 0.83C 1.73P 0.33), 1.16 (95%CI = 0.74 1.83P 0.52), 0.80 (95%CI = 0.58C 1.10P 0.17). 1.15 (95%CI: 0.662.00); 1.11 (95%CI: 0.761.62); 0.46 (95%CI: 0.131.55); 1.11 (95%CI: 0.761.62); 0.46 (95%CI: 0.131.55; 0.21). Using RevMan5.2 software to draw the inverted funnel graph, all the results except the rate of rebleeding (within 42 days) showed that the graph was basically symmetrical, indicating that the possibility of publication bias was small. The meta analysis, which excluded each study one by one, showed no significant change in aggregate sensitivity and specificity, which indicated that the stability of the literature included was good. Conclusion: there is no significant difference in early hemostasis rate, rebleeding rate, mortality and adverse reaction rate between octreotide group and sclerotherapy group in the treatment of cirrhosis esophageal variceal bleeding. Sclerotherapy is not superior to octreotide in the treatment of esophageal variceal bleeding due to cirrhosis.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R575.2

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