在血液出血的内镜控制后,患有出血的胃的患者的预防性跨动脉栓塞
Dennis Zetner1, Ida Roost2, Jacob Rosenberg3
1Department of Radiology, North Zealand Hospital, Copenhagen University Hospital, Hilleroed, Denmark.
The Cochrane database of systematic reviews
|February 10, 2025
概括
治疗出血性胃潰瘍后的预防性跨动脉栓塞 (TAE) 显示,低确定性证据表明,不减少再出血或死亡率. 然而,TAE可能会缩短住院时间,这需要进一步研究.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 临床试验 临床试验
背景情况:
- 流血性胃潰瘍需要迅速進行血靜,患者面臨重新出血的風險.
- 预防性跨动脉栓塞 (TAE) 正在探索,以防止在血液静止后再次出血.
- 评估TAE在减少再出血和改善患者结果方面的有效性至关重要.
研究的目的:
- 评估预防性TAE与单独的内镜血液静止,以评估出血性胃潰瘍患者的再出血风险.
- 为了比较预防性TAE和标准护理之间的再干预率,死亡率和住院时间.
主要方法:
- 对前性随机对照试验的系统审查和元分析.
- 在多个数据库 (CENTRAL,MEDLINE,Embase等) 进行了搜索. 在2023年8月之前.
- 包括的研究评估了在出血性胃潰瘍患者的预防性TAE,并成功进行了内镜血静.
主要成果:
- 两项研究 (346名参与者) 显示,低确定性证据表明,预防性TAE并没有显著减少再出血,再干预或30天死亡率.
- 随着预防性TAE (MD-2.41天),观察到可能减少住院时间.
- 由于在包含的研究中缺乏盲目化,因此存在高性能和检测偏差的风险.
结论:
- 低确定性证据表明,预防性TAE并不能显著降低腹出血后的再出血,再干预或死亡率.
- 预防性TAE可能会缩短住院时间,但需要进一步研究.
- 需要进行更大规模的试验来确认研究结果并调查其他不良事件.
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