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目的:对套扎疗法与硬化疗法治疗肝硬化食管静脉曲张出血的疗效进行系统评价．方法:通过Medline、EMBase和中国期刊全文数据库检索1985-01／2005-11发表的有关硬化疗法与套扎疗法治疗肝硬化食管静脉曲张出血相关文献,并采用RevMan4．2．8进行Meta分析．结果:按照入选标准,有7项前瞻性随机对照临床试验纳入．Meta分析结果显示,硬化疗法在治疗肝硬化食管静脉曲张中的再出血率高于套扎疗法(RR=1．32,95％CI:1．10-1．57, P<0．05);而在降低死亡率方面二者相似(RR= 1．24,95％CI:0．99-1．55,P>0．05)．结论:套扎疗法较硬化疗法在治疗肝硬化食管静脉曲张中能更好的预防再出血,在降低死亡率方面无差异．
OBJECTIVE: To systematically evaluate the efficacy of ligation and sclerotherapy in the treatment of hepatic cirrhosis with esophageal varices bleeding. Methods: The literature about the treatment of cirrhosis esophageal varices with sclerotherapy and ligation between January 1985 and November 2005 was retrieved by Medline, EMBase and Chinese Journal Full-text Database. Meta-analysis was performed by RevMan 4.2.8. Results: According to the inclusion criteria, seven prospective randomized controlled trials were included. Meta - analysis showed that the rate of rebleeding of cirrhosis esophageal varices was higher than that of ligation therapy (RR = 1.32, 95% CI: 1.10-1.57, P <0.05). They were similar in reducing mortality (RR = 1.24, 95% CI: 0.99-1.55, P> 0.05). CONCLUSIONS: Ligation versus sclerotherapy provides better prevention of rebleeding in the treatment of cirrhosis esophageal varices, with no difference in reducing mortality.