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对内镜注射治疗可见血管的胃出血的受控试验
R B Oxner1, N J Simmonds, D J Gertner
1Department of Gastroenterology, Oldchurch Hospital, Romford, Essex, UK.
Lancet (London, England)
|April 18, 1992
概括
内镜注射治疗显著减少了患有胃潰瘍的患者的再出血. 这种可访问的疗法提供了诸如降低死亡率和减少手术需求等好处,使其适合常规使用.
科学领域:
- 胃肠病学 胃肠病学
- 进行内镜干预.
- 胃肠道出血管理 胃肠道出血管理
背景情况:
- 输内镜注射治疗出血的胃潰瘍已在主要中心取得成功.
- 在一般医院的实施仍然有限.
- 这项研究旨在评估其在地区普通医院环境中的有效性.
研究的目的:
- 进行前性,随机化,受控试验的内镜注射治疗出血的胃.
- 评估这种干预对再出血率,死亡率和手术需要的影响.
- 为了确定在一般医院常规使用的可行性.
主要方法:
- 一项前性,随机化,受控试验,涉及555名急性上部胃肠道出血的患者.
- 在入院后24小时内对所有患者进行内镜检查.
- 93名患有和可见血管的患者被随机分配到接受注射治疗 (上腺素和乙醇胺酸盐) 或标准护理.
主要成果:
- 在注射治疗组 (16.7%) 与对照组 (46.7%) 相比,复出血明显减少,p = 0.011.
- 治疗组的死亡率较低 (8.3%与20%相比),手术需求减少 (8.3%与17.8%相比),平均输血需求较低.
- 医疗团队对所提供的内镜治疗失明了.
结论:
- 内镜注射治疗显著降低了患有出血性胃的患者的复出出血率.
- 这种干预提供了潜在的好处,包括降低死亡率,手术干预和输血需求.
- 该疗法具有成本效益,广泛适用,适合在地区普通医院常规使用,用于高风险患者.
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