在上胃肠道出血时,应该进行预防性内管道输入吗?
Syed Bilal Pasha1, Zahid Ijaz Tarar2, Harleen Chela2
1Gastroenterology and Hepatology, University of Missouri, Columbia, USA.
Cureus
|August 15, 2024
概括
针对急性上部胃肠道出血的预防性内内输管治疗增加了肺炎的风险和住院时间. 在接受内镜检查的住院患者中,它不会显著增加死亡率或吸收风险.
科学领域:
- 胃肠病学 胃肠病学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 在内镜检查急性胃肠道出血期间,最佳的气道管理仍在争论中.
- 之前的元分析已经探索了干预措施,但缺乏共识.
- 这项研究重新评估了该患者群体的预防性内内输管 (PEI).
研究的目的:
- 重新评估PEI对预防急性上部胃肠道出血的内镜并发症的影响.
- 分析包括肺炎,住院时间,吸气和死亡率在内的结果.
- 为临床决策提供最新的证据.
主要方法:
- 系统审查和对2024年之前发表的研究进行元分析.
- 包括11项研究 (10项追溯,1项前性),比较PEI与没有输管治疗.
- 随机效应模型用于计算关键结果的几率比率和平均差异.
主要成果:
- PEI与肺炎的几率显著增加 (OR = 5.83) 和住院时间更长 (MD = 0.84天) 相关.
- 没有观察到死亡率 (OR = 1.68) 或渴望 (OR = 2.79) 的统计学上显著增加.
- 分析包括7332名住院患者,患有急性上部胃肠道出血.
结论:
- 在急性上部胃肠道出血的食管胃肠道透视前PEI与肺炎增加和长时间住院有关.
- 证据不支持PEI的死亡率或愿望风险显著增加.
- 目前的调查结果表明,需要仔细考虑PEI的风险和收益.
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