| ObjectiveTo evaluate the diagnostic and therapeutic value of urgent colonoscopy-within 24h in acute lower gastrointestinal bleeding.MethodsDatabases such as PubMed,Springer,Web of Science,CNKI,,Vip and WanFang data were searched to select the studies about colonoscopy in dignosing and treating acute lower gastrointestinal bleeding,and the references of included studies were also retrospected.The retrieval time was from inception to November 30,2016.Discuss the analyze the bowel preparation methods,safety and timing of colonoscopy for acute lower gastrointestinal bleeding in order to evaluate the diagnostic and therapeutic value of urgent colonoscopy within 24h in acute lower gastrointestinal bleeding and find the best colonoscopy strategy.ResultsA total of 1583 articles on the diagnostic and therapeutic value of urgent colonoscopy within 24h in acute lower gastrointestinal bleeding were searched.Finally 9 articles were included.The result of the Meta analysis is following:There were no significant differences in the examination rate[RR=0.92,95%CI(0.78,1.09),P=0.32],total diagnostic rate[RR=1.03,95%CI(0.88,1.21),P=0.71]mortality[RR=1.95,95%CI(0.49,7.76),P=0.34],rebleeding rate[RR=1.05,95%CI(0.62,1.79),P=0.85]and total PRBC[MD=-0.98,95%CI(-2.42,0.46),=0.18]between urgent colonoscopy within 24h and elective colonoscopy after 24h.But there were a significant difference in the endoscopic hemostasis[RR=1.07,95%CI(1.03,1.11),P=0.0002]and hospital days[MD=-2.86,95%CI(-5.39,-0.33),P=0.03].ConclusionUrgent colonoscopy within 24h has a higher rate of endoscopic hemostasis and can shorten hospital days.At the same time,urgent colonoscopy within 24h doesn't affect the rate of endoscopic hemostasis?hemorrhage mortality?rebleeding rate and total PRBC transfusion requirement.So for patients with high risk of continuous bleeding or massive bleeding,it is recommended that urgent colonoscopy should be underwent within 24 hours when the hemodynamic is stable. |
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