止血粉单药治疗与传统内镜治疗对非静脉曲张性消化道出血的疗效对比：荟萃分析和试验序列分析。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy Pub Date : 2025-03-01 DOI:10.1016/j.gie.2024.08.042

Kai Liu MD , Wei Zhang MD , Li Gao MD , Jiawei Bai MD , Xin Dong MD , Yue Wang MD , Hui Chen MD , Jiaqiang Dong MD , Nian Fang MD , Ying Han MD , Zhiguo Liu MD

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引用次数: 0

摘要

背景和目的：止血粉（HP）是一种治疗非静脉曲张性消化道（GI）出血的新型止血方法。本荟萃分析旨在评估止血粉单药治疗与传统内镜治疗（CET）治疗非静脉曲张性消化道出血的疗效：方法：系统检索了从开始到2023年10月16日的PubMed、Embase和Cochrane图书馆数据库。主要结果为初始止血率和30天再出血率。荟萃分析后，还进行了试验序列分析（TSA），以减少随机误差风险并验证结果：荟萃分析包括 8 项研究，共纳入 653 名患者。鉴于存在明显的异质性，所有分析均分为恶性肿瘤相关和非恶性肿瘤相关消化道出血病变。对于前者，与 CET 相比，HP 单药治疗可显著提高初始止血率和 30 天再出血率（相对风险 [RR] 1.50，95% 置信区间 [CI] 1.28 - 1.75，P < .001；RR .32，95% CI .12 - .86，P = .02），TSA 支持上述结果。对于非恶性肿瘤相关的消化道出血，HP单药治疗和CET的初始止血率和30天再出血率相似（RR 1.08，95% CI .98 - 1.19，P = .11；RR 1.15，95% CI .46 - 2.90，P = .76），但TSA未能证实上述结果：总之，就恶性肿瘤相关消化道出血患者的初始止血率和30天再出血率而言，HP单药治疗优于CET。然而，它们对非恶性肿瘤相关消化道出血的相对疗效仍有待解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Efficacy of hemostatic powder monotherapy versus conventional endoscopic treatment for nonvariceal GI bleeding: a meta-analysis and trial sequential analysis

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Efficacy of hemostatic powder monotherapy versus conventional endoscopic treatment for nonvariceal GI bleeding: a meta-analysis and trial sequential analysis

Background and Aims

Hemostatic powder (HP) is a novel hemostasis modality for nonvariceal GI bleeding. This meta-analysis was performed to evaluate the efficacy of HP monotherapy versus conventional endoscopic treatment (CET) for nonvariceal GI bleeding.

Methods

PubMed, EMBASE, and Cochrane Library databases were systematically searched from inception to October 16, 2023. The primary outcomes were the initial hemostatic rate and the 30-day recurrent bleeding rate. After the meta-analysis, a trial sequential analysis (TSA) was also conducted to decrease the risk of random errors and validate the result.

Results

The meta-analysis included 8 studies, incorporating 653 patients in total. Given significant heterogeneity, all analyses were segregated into malignancy-related and nonmalignancy-related GI bleeding lesions. For the former, HP monotherapy significantly improved the initial hemostasis rate and 30-day recurrent bleeding rate compared with CET (relative risk [RR], 1.50; 95% confidence interval [CI], 1.28-1.75; P < .001; RR, .32; 95% CI, .12-.86; P = .02, respectively), and TSA supported the results. For nonmalignancy-related GI bleeding, HP monotherapy and CET have similar initial hemostasis and 30-day recurrent bleeding rates (RR, 1.08; 95% CI, .98-1.19; P = .11; RR, 1.15; 95% CI, .46-2.90; P = .76, respectively), but the TSA failed to confirm the results.

Conclusions

HP monotherapy surpassed CET in terms of the initial hemostasis rate and 30-day recurrent bleeding rate for patients with malignancy-related GI bleeding. However, their relative efficacy for nonmalignancy-related GI bleeding remains unresolved.

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来源期刊

Gastrointestinal endoscopy 医学-胃肠肝病学

CiteScore

10.30

自引率

7.80%

发文量

1441

审稿时长

38 days

期刊介绍： Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.