穿孔的胃潰瘍
Kjetil Søreide1, Kenneth Thorsen2, Ewen M Harrison3
1Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Lancet (London, England)
|October 14, 2015
概括
穿孔性胃的治疗需要早期手术和败血症控制. 需要更多高质量的试验来改善临床决策并降低这种常见紧急情况的高死亡率.
科学领域:
- 胃肠病学
- 紧急医疗
- 外科研究
背景情况:
- 穿孔性胃潰瘍 (PPU) 是全球嚴重的緊急情況,死亡率高達30%.
- 有限的高质量研究阻碍了对PPU的最佳临床决策.
- 全球存在人口和病因差异,影响PPU结果.
研究的目的:
- 总结目前关于穿孔性胃治疗的证据.
- 确定PPU临床试验的研究缺口和未来方向.
主要方法:
- 关于PPU的随机试验和已发表的文献的审查.
- 影响PPU人口结构,原因和死亡率的因素分析.
- 评估当前的治疗策略,包括手术和非手术方法.
主要成果:
- 早期手术 (腹腔镜或开放修复) 和败血症治疗对于PPU至关重要.
- 非手术和内镜方法有希望,但需要进一步的试验验证.
- 临床预测规则的准确性各不相同,需要改进证据.
结论:
- 迫切需要高质量,低偏差的试验来推进PPU管理证据.
- 进一步的研究应该集中在优化败血症护理包和术后监测.
- 在全球范围内标准化PPU护理需要强有力的临床试验数据.
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