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首页> 外文期刊>European journal of gastroenterology and hepatology >Endoscopic variceal ligation combined with argon plasma coagulation versus ligation alone for the secondary prophylaxis of variceal bleeding: a systematic review and meta-analysis
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Endoscopic variceal ligation combined with argon plasma coagulation versus ligation alone for the secondary prophylaxis of variceal bleeding: a systematic review and meta-analysis

机译：内镜静脉结扎结合氩等离子体凝血与单独连接，用于静脉曲张出血的二次预防：系统评价和荟萃分析

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Endoscopic variceal ligation (EVL) is often recommended as an effective method for the treatment of esophageal varices, despite the important tendency of variceal recurrence. Recent studies indicate that combining EVL with argon plasma coagulation (APC) may be a more effective therapy than ligation alone. To investigate these findings, we carried out a systematic review and metaanalysis to compare the safety and efficacy of EVL combined with APC versus ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage. All studies were searched through PubMed, the Cochrane Library, and Science Direct. The outcome measures were relative risk (RR) or risk difference with 95% confidence intervals (CIs) for dichotomous data and standardized mean difference for continuous data. Heterogeneity was calculated using the chi 2 and the I-2-tests. Two investigators independently identified four randomized-controlled trials included in the research. The variceal recurrence rate was significantly lower in the combined therapy group (RR = 0.19, 95% CI: 0.09-0.41, P = 0.000). The bleeding recurrence and mortalities in the two groups showed no significant differences (RR = 0.29, 95% CI: 0.08-1.04, P = 0.058; risk difference = -0.02, 95% CI: -0.08-0.04, P = 0.576, respectively). Although the pyrexia incidence rate was significantly higher in the combined group (RR = 3.42, 95% CI: 1.56-7.48, P = 0.002), there was intertrial heterogeneity (I-2 = 52.5%, P = 0.097). EVL combined with APC is superior to ligation alone for endoscopic variceal recurrence without severe adverse events in secondary prophylaxis against esophageal variceal bleeding. More high-quality studies are needed to strengthen this conclusion. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
机译：尽管变形复发的重要趋势，但通常建议使用内镜静脉连接（EVL）作为治疗食管静脉曲张的有效方法。最近的研究表明，将EVL与氩等离子体凝固（APC）组合，可能是单独连接的更有效的治疗。为了调查这些发现，我们进行了系统审查和细胞分析，以比较EVL与APC与连接的安全性和功效仅用于食管静脉血出血的二次预防。所有研究都通过PubMed，Cochrane图书馆和科学直接搜查。结果措施是相对风险（RR）或风险差，具有95％的置信区间（CIS），用于二分数据，以及连续数据的标准化平均差异。使用CHI 2和I-2测试计算异质性。两位调查人员独立地确定了该研究中包含的四项随机对照试验。组合治疗组的静脉复发率显着降低（RR = 0.19,95％CI：0.09-0.41，P = 0.000）。两组中出血复发和死亡率没有显着差异（RR = 0.29,95％CI：0.08-1.04，P = 0.058;风险差异= -0.02,95％CI：-0.08-0.04，P = 0.576 ）。虽然联合基团的Pyrexia发病率明显高（RR = 3.42,95％CI：1.56-7.48，P = 0.002），但存在相位异质性（I-2 = 52.5％，P = 0.097）。 EVL与APC结合优于连接内窥镜静脉曲张复发，而没有严重不良事件的二次预防对食管静脉曲张出血。需要更高质量的研究来加强这一结论。版权所有（C）2017 Wolters Kluwer Health，Inc。保留所有权利。

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