前内镜血红素与甲托克洛普拉米德用于上部胃肠道出血:系统性审查和网络元分析
Ravi Teja Pasam1, Kanwal Bains2, Srilekha Chava3
1Department of Hospital Medicine, Wentworth-Douglass Hospital, Dover, NH, USA.
Clinical endoscopy
|July 4, 2025
概括
与安慰剂相比,红素改善了上部胃肠道出血 (UGIB) 的内镜可视化. 梅托克洛普拉米德和胃洗对UGIB内镜没有显著的益处.
科学领域:
- 胃肠病学 胃肠病学
- 临床内镜检查 临床内镜检查
- 药理学 药理学是指药理学的学科.
背景情况:
- 在上部胃肠道出血 (UGIB) 中,对前内镜血红素与美托克洛普拉米德进行有限的对比试验.
- 需要进行网络元分析来比较这些药物和UGIB管理的胃洗 (GL).
研究的目的:
- 为了比较前内镜血红素和美托克洛普拉米德在上部胃肠道出血 (UGIB) 的疗效.
- 评估这些药物和胃洗 (GL) 对内镜可视化和患者结局的影响.
主要方法:
- 进行了随机对照试验的系统审查和网络元分析 (NMA).
- 在Medline,Embase和Cochrane数据库中搜索了与红素或美托克洛普拉米德与安慰剂和/或GL进行比较的试验.
- 主要结局:足够的粘膜可视化;次要结局:可视化得分,持续时间,诊断,第二次内镜检查,输血,死亡率,住院.
主要成果:
- 包括16项研究,涉及1447名患者.
- 与对照组相比,红素显示出明显更好的内镜可视化得分和足够的粘膜可视化.
- 红素还在第二次内镜检查,输血需求和住院时间方面表现出好处.
结论:
- 红素应考虑作为上部胃肠道出血 (UGIB) 的前内镜干预措施.
- 目前的证据不支持在UGIB内镜检查中常规使用美托克洛普拉米德或胃洗.
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