医学
荟萃分析
科克伦图书馆
内科学
置信区间
相对风险
止血
梅德林
上消化道出血
内窥镜检查
政治学
法学
作者
Kai Liu,Li Gao,Jiawei Bai,Lulu Wang,Shengmei Zhu,Xiaohui Zhao,Ying Han,Zhiguo Liu
标识
DOI:10.1111/1751-2980.13191
摘要
Objectives Nonvariceal gastrointestinal bleeding (NVGIB) is a common medical condition with significant mortality and morbidity. Several types of hemostatic modalities are currently available in clinical setting. This systematic review and network meta‐analysis aimed to assess the efficacy of these modalities in treating NVGIB. Methods PubMed, EMBASE, and the Cochrane Library databases were searched for studies that compared the efficacy of different hemostatic techniques (over‐the‐scope clip [OTSC], hemostatic powder [HP] and conventional endoscopic treatment [CET]) for NVGIB published up to June 2022. The 30‐day rebleeding rate was regarded as the primary outcome. We performed pairwise and network meta‐analyses for all treatments. The heterogeneity and transitivity were evaluated. Results Twenty‐two studies were included. Regarding the 30‐day rebleeding rate, OTSC and HP plus CET showed superior efficacy in treating NVGIB compared with CET (OTSC vs CET: relative risk [RR] 0.42, 95% confidence interval [CI] 0.28–0.60; HP plus CET vs CET: RR 0.40, 95% CI 0.17–0.87), while OTSC and HP plus CET had comparable efficacy (RR 0.95, 95% CI 0.38–2.31). HP plus CET ranked the highest in the network ranking estimate. The sensitivity analysis showed that it was not robust that OTSC was superior to CET regarding the short‐term rebleeding rate and the initial hemostasis rate. While all‐cause mortality, bleeding‐related mortality and necessity of surgical or angiographic salvage therapy showed no statistically significant difference. Conclusion OTSC and HP plus CET significantly reduced 30‐day rebleeding rate compared to CET and had comparable efficacy in the treatment of NVGIB.
科研通智能强力驱动
Strongly Powered by AbleSci AI