质子抑制剂在预防内镜缩膜切除术后延迟出血方面没有作用:一项前性随机对照试验
Zhengping Yu1, Jinli He1, Ronglai Cao1
1Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Jiangxi Clinical Research Center for Gastroenterology, Nanchang, China.
质子抑制剂 (PPI) 不能防止在内透镜切除术 (EST) 后延迟出血. 这项随机试验在PPI和正常盐水组之间没有发现出血率或严重程度的显著差异,这表明PPI对后EST出血预防不有效.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术 进行内镜手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 血液流血是内镜逆行胆血管细胞造影 (ERCP) 后的一个常见并发症,主要是由于内镜膜切除术 (EST).
- 质子抑制剂 (PPI) 预防EST后出血的疗效仍然不确定.
- 为了解决这一知识差距,进行了一项随机对照试验.
研究的目的:
- 调查PPI在预防EST后延迟出血方面的有效性.
- 为了比较接受PPI与正常盐水治疗的患者中后EST延迟出血的发生率和严重程度.
主要方法:
- 一项随机对照试验,涉及290名接受ERCP与EST的患者.
- 患者被分配接受静脉注射埃索梅普拉,然后口服埃索梅普拉 (PPI组) 或静脉注射正常盐水 (NS组).
- 主要终点是ERCP后30天内延迟出血的发生率和严重程度.
主要成果:
- 总共有6名患者经历了延迟出血 (2.14%的发病率).
- 在PPI组有3个病例 (2.12%),在NS组有3个病例 (2.16%).
- 在PPI和NS组之间没有观察到出血发生率或严重性的显著差异 (p=1,000).
结论:
- 预防性使用PPI并不能降低EST后延迟出血的发生率或严重程度.
- 目前的证据不支持常规使用PPI来预防EST后出血.
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