在患有急性胃潰瘍出血的患者內視止血後,例行第二檢視內視鏡的有效性:系統性評論和元分析
Harold Benites-Goñi1, Jessica Alférez-Andía2, Alejandro Piscoya3
1Unidad de Revisiones Sistemáticas y Meta-análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola. Lima, Peru; Hospital Nacional Edgardo Rebagliati Martins. Lima, Peru.
概括
预定第二次观察内镜对急性胃潰瘍出血的单次内镜没有显著的益处. 这次审查没有发现再出血,手术或死亡率的差异,这表明常规使用并不更有效.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 基于证据的医学基于证据的医学.
背景情况:
- 急性胃潰瘍出血 (PUB) 是致病率和死亡率的重要原因.
- 内镜干预对于管理PUB至关重要.
- 预定第二次内镜在改善结果中的作用仍在争论中.
研究的目的:
- 在患有急性胃潰瘍出血的患者中,與單次內視鏡相比,評估預定的第二檢視內視鏡的有效性.
- 为了评估对再出血的影响,需要进行手术,死亡率和输血要求.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了四个相关RCT的数据库.
- 主要结局:重新出血. 二次结果:手术,死亡率,输血单位 (NUBT).
- 使用随机效应模型分析数据,并通过GRADE评估证据质量.
主要成果:
- 包括10个RCT (1513名患者).
- 两组之间没有发现重出血 (中度QOE),手术 (中度QOE) 或死亡率 (中度QOE) 的显著差异.
- 在NUBT (低QOE) 中没有显著差异.
结论:
- 常规的二次内镜对于患有急性胃潰瘍出血的患者来说,并不比单次内镜更有效.
- 目前的证据不支持在这个患者群体中常规使用预定第二查看内镜.
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