MERGE TARGET.dbname.dbo.tablename AS target
USING SOURCE.dbname.dbo.tablename AS source ON
source.field1 = target.field1 COLLATE Lithuanian_BIN AND
source.field2 = target.field2 AND
source.field3 = target.field3 AND
source.field4 = target.field4
WHEN NOT MATCHED THEN INSERT (field1, field2, field3, field4)
VALUES (source.field1, source.field2, source.field3, source.field4)
WHEN NOT MATCHED BY SOURCE THEN
DELETE
OUTPUT $action, DELETED.*, INSERTED.*;