Meta Analysis Of Therapeutic Effect Of PVA And GS Bronchial Artery Embolization In The Treatment Of Massive Hemoptysis

Objective: To compare therapeutic effects of polyvinyl alcohol(PVA) and gelatin sponge(GS) bronchial artery embolizations(BAE) in the treatment of massive hemoptysis through systematic evaluation of embolization materials commonly used in China and abroad with variable therapeutic effects, and to provide evidence for the selection of embolization agents in the treatment of clinical intervention.Methods: Literature databases including CNKI, Wanfang, VIP, CBM, Pub Med, the Cochrane Library, EMBASE and SCI were searched by using computer for articles about the treatment of massive hemoptysis with PVA, and the time period was set from inception to December 2015. The inclusion and exclusion criteria were used to collect articles about PVA and GS with a clear comparative analysis. The quality of articles was then evaluated and the relevant data were extracted. Rev Man 5.3 software was used to analyze and describe the effect of the research materials.Results: A total of 15 articles containing 1227 patients were included, 742 patients embolized with PVA and 485 patients embolized with GS, but only five studies were randomized controlled trials, and the research quality was not high enough. Evaluation of therapeutic effects: the immediate hemostasis effects were good and there was no significant difference [RR=1.02, P=0.53]; but 3-month [RR=0.48, P=0.02], 6-month [RR=0.30, P=0.0005], 12-month [RR=0.33, P<0.00001], and more than 1 years[RR=0.31, P<0.00001] recurrence rates were statistically different between PVA and GS.Conclusion: The hemostatic effects of PVA and GS were good and there was no significant difference in the immediate hemostasis effect, although there was a certain risk of recurrence after surgery. PVA may be superior to GS in reducing the recurrence rate of the middle and long term after surgery. Subject to the quality of the original literature, and the possible publication bias, the conclusions will need to be verified by more higher quality, larger population, well-designed randomized controlled trials.