关键词: 食管静脉曲张出血, 硬化剂注射, 奥曲肽, 系统评价

Abstract: Objective To evaluate the efficacy of sclerotherapy plus octreotide for esophageal variceal hemorrhage. Methods We searched CBM,the Cochrane Library,the Cochrane Controlled Trials Register,MEDLINE,EMBASE and SCIE for randomized controlled trials about sclerotherapy plus octreotide versus sclerotherapy only. The Meta-analyses were conducted by using The Cochrane Collaboration’s RevMan 4.2 software. Results Five randomized controlled trials involving 511 patients were included including 255 patients in sclerotherapy plus octreotide and 256 patients in sclerotherapy alone group. The rates of early hemostasis,the rates of rebleeding,the rates of mortality and adverse events were analyzed. Meta-analyses showed that the early hemostasis in sclerotherapy plus octreotide group was better than in sclerotherapy group（OR=2.65,95%CI=1.66 to 4.23）;rebleeding was more frequent in sclerotherapy group（OR= 0.52,95%CI=0.32 to 0.84）;However,the incidence of death was similar in both groups（OR=0.75,95%CI=0.44 to 1.29）;The most frequent adverse events was hyperglycemia,esophageal ulcer,hepatic encephalopathy and headache,and it showed no significant difference in the two groups. Funnel plot showed symmetrical,suggesting the lover possibility of publication bias. Conclusions Sclerotherapy plus octreotide therapy is better for hemostasis of esophageal variceal bleeding than sclerotherapy alone.

Key words: Esophageal variceal bleeding, Sclerotherapy, Octreotide, Meta analysis