在急性胃潰瘍出血時,最佳的腎上腺素注射量. 一个系统的审查和元分析
Alba Lira1, Leticia Hernández2, Myriam Martell3
1Endoscopy Unit. Gastroenterology, Institut d'Investigació i Innovació Parc Taulí I3PT. Hospital Universitari Parc Taulí.
Revista espanola de enfermedades digestivas
|December 18, 2025
概括
在急性胃潰瘍出血 (APUB) 的內視治療中,大量注射腎上腺素 (高達30cc) 改善了永久性血靜率. 虽然不良事件增加,但这种方法在APUB管理中似乎是安全和有效的.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 医学研究 医学研究
背景情况:
- 急性胃出血 (APUB) 是一个重大的临床挑战.
- 内镜治疗是管理APUB的基石.
- 上腺素注射是一种常见的内镜静血技术,但最佳体积仍在争论中.
研究的目的:
- 系统地审查和分析APUB不同注射量的上腺素的疗效和安全性.
- 为了确定在APUB患者中实现永久血静的最佳上腺素体积.
主要方法:
- 从1986年到2025年1月发表的RCT的系统文献搜索.
- 包括RCT比较不同的上腺素容量用于APUB内镜治疗.
- 主要结局:永久的血液静止. 二次结果:不良事件,救援治疗,死亡率.
- 使用随机效应模型进行元分析以估计OR和95%CI.
主要成果:
- 分析了4个RCT,包括556名患者.
- 大量的上腺素注射 (高达30cc) 显著改善了永久血静率 (91%对77%,OR:2.90).
- 大量的不良事件更频繁 (33%对3%),主要是腹部疼痛. 穿孔发生>35cc.
结论:
- 大量的上腺素 (高达30cc) 的内镜注射是安全的,并增强了APUB的永久血静.
- 较低的注射量与较低的血静率有关.
- 需要进一步的试验来评估组合疗法中更大的体积.
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