Gong Cheng, Qin Xian, Yang Jian, Guo Tao
Department of General Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
School of Nursing, Huanggang Polytechnic College, Huanggang, 438002, China.
Gastroenterol Res Pract. 2017;2017:9216172. doi: 10.1155/2017/9216172. Epub 2017 Jun 6.
To determine the best anticoagulation strategy for the patients who underwent splenectomy with cirrhosis through network meta-analysis.
We conducted a systematic review of the literature in PubMed, Embase, and the Cochrane Library database. We extracted data on incidence of Portal vein system thrombosis (PVST) from studies that compared various anticoagulation strategies for use with patients who underwent splenectomy with cirrhosis. Network meta-analysis was conducted in ADDIS by evaluating the different incidence of PVST. Consistency and inconsistency models were developed to identify differences among the therapeutic strategies. Cumulative probability was utilized to rank the strategies under examination. Results. A total of 11 studies containing 1153 patients were included in the network meta-analysis. The results revealed that the application of Antithrombin III was the best anticoagulation option for patients who underwent splenectomy with cirrhosis (P = 0.59). The data of consistency and inconsistency models exhibited basically consistent and showed good convergence.
Application of Antithrombin III seemed to be the best anticoagulation strategy for cirrhotic patients who underwent splenectomy and should be considered a first-choice clinical reference.
通过网状Meta分析确定肝硬化患者脾切除术后的最佳抗凝策略。
我们对PubMed、Embase和Cochrane图书馆数据库中的文献进行了系统评价。我们从比较肝硬化脾切除患者不同抗凝策略的研究中提取门静脉系统血栓形成（PVST）发生率的数据。通过评估PVST的不同发生率，在ADDIS中进行网状Meta分析。建立一致性和不一致性模型以识别治疗策略之间的差异。利用累积概率对所研究的策略进行排序。结果：共有11项研究（包含1153例患者）纳入网状Meta分析。结果显示，抗凝血酶III的应用是肝硬化脾切除患者最佳的抗凝选择（P = 0.59）。一致性和不一致性模型的数据基本一致且显示出良好的收敛性。
抗凝血酶III的应用似乎是肝硬化脾切除患者最佳的抗凝策略，应被视为首选临床参考。
