连续或间歇的特里普林素输液用于门门高血压:系统性审查和元分析
Mona Hassan1, Nooraldin Merza2, Yusuf Nawras3
1Department of Gastroenterology.
Annals of medicine and surgery (2012)
|October 9, 2023
概括
连续注射terlipressin比间歇注射更有效,用于管理门高血压并发症,如再出血和治疗失败. 需要进一步的研究来证实对死亡率和住院时间的益处.
科学领域:
- 肝病学和胃肠病学 肝病学和胃肠学
- 临床药理学 临床药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 门高血压是慢性肝病的严重并发症.
- 腹出血是一种与门门高血压相关的危及生命的风险.
- 特里压素是一种血管活性药物,用于控制水出血.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT).
- 为了比较连续与间歇性特里普林素输注的疗效和安全性.
- 为管理门性高血压提供基于证据的指导.
主要方法:
- 按照PRISMA标准进行系统审查和元分析.
- 在多个数据库 (MEDLINE,Scopus,Web of Science,CENTRAL) 进行搜索,截至2023年4月6日.
- 包括5项与395名患者的RCT,评估出血,治疗失败,不良反应和死亡率.
主要成果:
- 连续使用特利普林素显著减少了复出出血 (RR=0.43) 和治疗失败 (RR=0.22).
- 持续输液也导致较少的不良反应 (RR=0.52).
- 在平均动脉压,住院或死亡率方面没有发现显著差异.
结论:
- 连续注射terlipressin似乎优于间歇注射,以减少再出血,治疗失败和不良反应.
- 建议进行进一步的大规模RCT来证实这些发现.
- 进一步的研究应探讨连续使用特里普林素对死亡率和住院时间的影响.
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