| Background:Esophageal and gastric varices bleeding(EGVB) is one of the mostserious complications of portal hypertension, which has high mortality(43.5%). It seemsto be of great significance to prevent and treat EGVB actively. Propr-anolol(PPL) andendoscopic variceal ligation (EVL) have been used widely in oesophageal varices. Fornow, there still has been a controversy about the selection of EVL or PPL as thefirst-line preventive measures.Objectives: to make a comparision of the clinical efficacy of EVL and PPL andsafety in for the first bleeding and provide evidence-based medicine for clinicalpractice.Methods: Randomized controlled trials (RCTs) were retrieved in PubMed,ChinaBiological Medicine Databa-se(CNKI),. Medline and we also manually retrirved therelevant references.The retrieval date was from January1999to December2013. ThoseRCTs that did not meet the requirements were exclueded. The outcome indexes includedbleeding related mortality, total mortality, the incidence of portal hypertensivegastropathy(PHG), upper gastrointestinal bleeding and adverse events. Thismeta-analysis was applied with Revman5.2software to evaluate the quality of thisreserach and extracted the data. The results of this research were showed as95%confidence intervals (CI) and risk ratios (RR).Results: In total,10RCTs meet the requirements. PPL groups had495patients,EVL group had505patients.there was no difference between EVL and PPL in the incidence of bleeding related mortality[RR=0.84、95%CI（0.49,1.45）、P=0.53]， totalmortality[RR=1.10、95%CI （0.86,1.40）、 P=0.45], upper gastrointestinalbleeding[RR=0.77、95%CI（0.48,1.25）、P=0.29]、P=0.53]， and PHG[RR=1.17、95%CI（0.66,2.07）、P=0.59].Whereas, the incidence of adverse events of EVL groupwas higher than PPL group[RR=4.37,95%CI（2.28,8.36）,P=0.90].Conclusions:In contrast with EVL, PPL could decrease the risk of adverseevents.nevertheless,they had no influence on decrease of mortality, the incidence ofupper gastrointestinal bleeding and PHG,or related mortality. |
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