用氰基丙烯酸正丁酯进行经导管动脉栓塞治疗胃肠道出血：安全性和有效性的系统评价与荟萃分析
Transcatheter Arterial Embolization of Gastrointestinal Bleeding with N-Butyl Cyanoacrylate: A Systematic Review and Meta-Analysis of Safety and Efficacy.
作者信息
Kim Pyeong Hwa, Tsauo Jiaywei, Shin Ji Hoon, Yun Sung-Cheol
机构信息
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 86, Asanbyeongwon-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
出版信息
J Vasc Interv Radiol. 2017 Apr;28(4):522-531.e5. doi: 10.1016/j.jvir.2016.12.1220. Epub 2017 Feb 28.
PURPOSE
To evaluate the safety and efficacy of transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA) for the treatment of gastrointestinal (GI) bleeding via a meta-analysis of published studies.
MATERIALS AND METHODS
The MEDLINE/PubMed and EMBASE databases were searched for English-language studies from January 1990 to March 2016 that included patients with nonvariceal GI bleeding treated with transcatheter arterial embolization with NBCA with or without other embolic agents. The exclusion criteria were a sample size of < 5, no extractable data, or data included in subsequent articles or duplicate reports.
RESULTS
The cases of 440 patients (mean age, 63.8 y ± 14.3; 319 men [72.5%] and 121 women [27.5%]) from 15 studies were evaluated. Of these patients, 261 (59.3%) had upper GI bleeding (UGIB) and 179 (40.7%) had lower GI bleeding (LGIB). Technical success was achieved in 99.2% of patients with UGIB (259 of 261) and 97.8% of those with LGIB (175 of 179). The pooled clinical success and major complication rates in the 259 patients with UGIB in whom technical success was achieved were 82.1% (95% confidence interval [CI], 73.0%-88.6%; P = 0.058; I = 42.7%) and 5.4% (95% CI, 2.8%-10.0%; P = 0.427; I = 0.0%), respectively, and those in the 175 patients with LGIB in whom technical success was achieved were 86.1% (95% CI, 79.9%-90.6%; P = 0.454; I = 0.0%) and 6.1% (95% CI, 3.1%-11.6%; P = 0.382; I = 4.4%), respectively.
CONCLUSIONS
Transcatheter arterial embolization with NBCA is safe and effective for the treatment of GI bleeding.
目的
通过对已发表研究的荟萃分析，评估经导管动脉栓塞术使用氰基丙烯酸正丁酯（NBCA）治疗胃肠道（GI）出血的安全性和有效性。
材料与方法
检索MEDLINE/PubMed和EMBASE数据库，查找1990年1月至2016年3月期间的英文研究，这些研究纳入了接受经导管动脉栓塞术使用NBCA（无论是否联合其他栓塞剂）治疗的非静脉曲张性GI出血患者。排除标准为样本量<5、无可提取数据，或数据包含在后续文章或重复报告中。
结果
评估了来自15项研究的440例患者（平均年龄63.8岁±14.3岁；男性319例[72.5%]，女性121例[27.5%]）。其中，261例（59.3%）为上消化道出血（UGIB），179例（40.7%）为下消化道出血（LGIB）。UGIB患者中99.2%（261例中的259例）和LGIB患者中97.8%（179例中的175例）技术成功。在技术成功的259例UGIB患者中，汇总的临床成功率和主要并发症发生率分别为82.1%（95%置信区间[CI]，73.0%-88.6%；P = 0.058；I² = 42.7%）和5.4%（95%CI，2.8%-10.0%；P = 0.427；I² = 0.0%），在技术成功的175例LGIB患者中分别为86.1%（95%CI，79.9%-90.6%；P = 0.454；I² = 0.0%）和6.1%（95%CI，3.1%-11.6%；P = 0.382；I² = 4.4%）。
结论
经导管动脉栓塞术使用NBCA治疗GI出血安全有效。
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