中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2015年
4期
275-280
,共6页
臧立娜%孙自勤%李文波%刘晓峰
臧立娜%孫自勤%李文波%劉曉峰
장립나%손자근%리문파%류효봉
食管和胃静脉曲张%出血%危险因素%Meta分析%内镜治疗
食管和胃靜脈麯張%齣血%危險因素%Meta分析%內鏡治療
식관화위정맥곡장%출혈%위험인소%Meta분석%내경치료
Esophageal and gastric varices%Hemorrhage%Risk factors%Meta-analysis%Endoscopic therapy
目的 探讨食管胃静脉曲张患者经内镜治疗后再出血危险因素. 方法 全面检索Medline、EMBASE及中国生物医学文献期刊数据库等,收集2000年1月至2013年5月有关食管胃静脉曲张经内镜治疗后再出血危险因素的文献.对符合要求的文献提取数据,采用Cochrane协作网提供的Review Manger软件(Revman 5.2)进行Meta分析. 结果 共收集16篇文献用于Meta分析,门静脉栓子比值比(OR)值为7.88,P＜0.00001;β-受体阻滞剂或硝酸盐类药物OR值为0.53,P=0.0008;套扎点SMD值为0.94,P＜0.01;白蛋白随访时间≤14d亚组标准化均数差(SMD)值为-0.89,P＜0.000 01;凝血酶原时间随访时间≤14d亚组SMD值为1.78,P＜0.000 01.结论 近期再出血的危险因素:门静脉栓子、原发性肝癌、门静脉直径、肝功能Child-Pugh C级、中大量腹水、凝血酶原时间、套扎点;远期再出血的危险因素:门静脉栓子、原发性肝癌、门静脉直径;近期及远期再出血的保护因素为β受体阻滞剂或硝酸盐类药物的应用.
目的 探討食管胃靜脈麯張患者經內鏡治療後再齣血危險因素. 方法 全麵檢索Medline、EMBASE及中國生物醫學文獻期刊數據庫等,收集2000年1月至2013年5月有關食管胃靜脈麯張經內鏡治療後再齣血危險因素的文獻.對符閤要求的文獻提取數據,採用Cochrane協作網提供的Review Manger軟件(Revman 5.2)進行Meta分析. 結果 共收集16篇文獻用于Meta分析,門靜脈栓子比值比(OR)值為7.88,P＜0.00001;β-受體阻滯劑或硝痠鹽類藥物OR值為0.53,P=0.0008;套扎點SMD值為0.94,P＜0.01;白蛋白隨訪時間≤14d亞組標準化均數差(SMD)值為-0.89,P＜0.000 01;凝血酶原時間隨訪時間≤14d亞組SMD值為1.78,P＜0.000 01.結論 近期再齣血的危險因素:門靜脈栓子、原髮性肝癌、門靜脈直徑、肝功能Child-Pugh C級、中大量腹水、凝血酶原時間、套扎點;遠期再齣血的危險因素:門靜脈栓子、原髮性肝癌、門靜脈直徑;近期及遠期再齣血的保護因素為β受體阻滯劑或硝痠鹽類藥物的應用.
목적 탐토식관위정맥곡장환자경내경치료후재출혈위험인소. 방법 전면검색Medline、EMBASE급중국생물의학문헌기간수거고등,수집2000년1월지2013년5월유관식관위정맥곡장경내경치료후재출혈위험인소적문헌.대부합요구적문헌제취수거,채용Cochrane협작망제공적Review Manger연건(Revman 5.2)진행Meta분석. 결과 공수집16편문헌용우Meta분석,문정맥전자비치비(OR)치위7.88,P＜0.00001;β-수체조체제혹초산염류약물OR치위0.53,P=0.0008;투찰점SMD치위0.94,P＜0.01;백단백수방시간≤14d아조표준화균수차(SMD)치위-0.89,P＜0.000 01;응혈매원시간수방시간≤14d아조SMD치위1.78,P＜0.000 01.결론 근기재출혈적위험인소:문정맥전자、원발성간암、문정맥직경、간공능Child-Pugh C급、중대량복수、응혈매원시간、투찰점;원기재출혈적위험인소:문정맥전자、원발성간암、문정맥직경;근기급원기재출혈적보호인소위β수체조체제혹초산염류약물적응용.
Objective To investigate the risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy.Methods Medline,EMBASE and the China Biology Medicine Database were searched for literature published between January 2000 to May 2013 on topics related to risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy.Data from each study that meet the requirements for analysis were extracted and subjected to meta-analysis.Results Sixteen studies were collected for use in this meta-analysis.The odds ratio (OR) value of portal vein embolus was 7.88 (P ＜ 0.00 001).The OR value of beta-blockers or nitrate medications was 0.53 (P =0.0 008).The standardized mean difference (SMD) value of number of ligation points was 0.94 (P ＜ 0.01).The SMD value of albumin in the subgroup with follow-up time of ≤ 14 days was-0.89 (P ＜ 0.00001),while the SMD value of prothrombin time in the subgroup with follow-up time of ≤ 14 days was 1.78 (P ＜ 0.00001).Conclusion Portal vein embolus,hepatocellular carcinoma,diameter of the portal vein,Child-Pugh classification C,moderate/excessive ascites,pmthrombin time,and number of ligation points were risk factors of gastroesophageal varices early rebleeding after therapeutic endoscopy.Portal vein embolus,hepatocellular carcinoma,and diameter of the portal vein were risk factors of gastroesophageal varices long-term rebleeding after therapeutic endoscopy.Beta blockers or nitrate medications were protective factors ofgastroesophageal varices rebleeding after therapeutic endoscopy.
