在外科手术期间使用的皮皮质或印梅他是否能改善胰腺二切除术的结果? 一个三臂,随机的安慰剂受控试验
Kislay Kant1, Zeeshan Ahmed1, Rohit Dama1
1Department of Surgical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
Annals of hepato-biliary-pancreatic surgery
|April 28, 2024
概括
抗炎药物 - - 皮和印米他辛并没有减少胰腺切除术后的重大并发症. 虽然皮降低了整体并发症,但在这项研究中,没有一种药物被证明对严重结局有效.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 胰腺二管切除术 (PD) 是一项复杂的手术,并发症率很高.
- 在PD之后的术后并发症可能包括胰腺,出血,延迟胃排空和手术部位感染.
- 抗炎药物正在研究其减轻这些并发症的潜力.
研究的目的:
- 评估皮 (H) 和印梅他辛 (I) 在减少胰腺切除术后重大并发症的疗效.
- 为了比较治疗组之间的整体并发症,临床相关的术后胰腺 (CR-POPF),延迟胃排空 (DGE),胰腺切除术后出血 (PPH) 和手术部位感染 (SSI) 的发生率.
主要方法:
- 一项随机对照试验,涉及105名接受PD的患者.
- 患者从术后的0至2天被分配给静脉注射皮,直肠印梅他辛或安慰剂.
- 结果,包括重大并发症 (Clavien-Dindo等级3-5),被盲目的调查人员评估.
主要成果:
- 在所有组中,主要并发症都相似 (8.6%的皮,5.7%的印米他辛,8.6%的安慰剂).
- 与安慰剂相比,皮显著减少了整体并发症 (45.7%vs. 80.0%,p=0.006).
- 在皮和安慰剂组之间,CR-POPF,PPH,DGE和SSI的发病率是可比的.
结论:
- 无论是皮,还是印梅他辛都没有显著减少胰腺切除术后的重大并发症.
- 皮在减少整体并发症方面显示出好处,但并不是严重的.
- 可能需要进一步的研究来探索替代抗炎策略或患者选择这些药物.
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