红霉素在急性上消化道出血紧急内镜检查中应用的系统评价  

Erythromycin infusion prior to emergency endoscopy for acute upper gastrointestinal bleeding: a systematic review

作　　者：周隽[1] 何继东[1] 欧阳晓波[1] 王一平[2] 

机构地区：[1]雅安市第二人民医院消化内科,四川省雅安市625000 [2]四川大学华西医院消化内科,四川省成都市610041

出　　处：《世界华人消化杂志》2009年第31期3273-3277,共5页World Chinese Journal of Digestology

摘　　要：目的:系统评价红霉素在急性上消化道出血紧急内镜检查中应用的有效性和安全性.方法:计算机检索Cochrane图书馆临床对照试验,Medline、PubMed及中国期刊全文数据库等中外文数据库.手工检索消化病学周会和美国胃肠病学学会会议论文集;查阅检索到所有文献的参考文献索引,手工检索文献.凡评价急性上消化道出血紧急内镜检查中红霉素应用的随机对照试验,无论语种、是否采用盲法均纳入,应用国际Cochrane协作网系统评价方法对其进行Meta分析.结果:共纳入3个试验包括245例患者.红霉素组与安慰剂组比较,2组在胃排空和需要二次内镜检查方面的差异有统计学意义(OR=5.10,95%CI:1.96-13.27,P=0.0008;OR=0.48,95%CI:0.27-0.88,P=0.02);内镜检查时间、输血量及住院时间的平均值差异无统计学意义(P=0.84、0.07及0.36);3篇试验均无不良反应的报道.结论:急性上消化道出血紧急内镜检查中应用红霉素,在改善内镜视野上是安全有效的.AIM： To determine the efficacy and safety of erythromycin infusion prior to emergency endoscopy for acute upper gastrointestinal bleeding. METHODS： A computer-based search of the Cochrane library, Medline, PubMed and China Journal Full-text database and a manual search of Gastroenterology Week and the American Gastroenterological Association Conference Proceedings to identify relevant controlled trials, regardless of language. The references were manually retrieved according to reference index. The randomized controlled trials that evaluated the use of erythromycin in endoscopy for acute upper gastrointestinal bleeding were included in our study. A meta-analysis was conducted using the method for Cochrane systematic review.RESULTS： Three trials involving 245 patients were included in the systematic review. The meta-analysis showed that erythromycin was superior to placebo in gastric emptying and sec-ond-look endoscopy （OR = 5.10 and 0.48; 95%CI： 1.96-13.27 and 0.27-0.88; P = 0.0008 and 0.02, respectively）, but no more effective than placebo in mean duration of endoscopy, mean blood transfusion volume and mean hospital stay （P = 0.84, 0.07 and 0.36, respectively）. No complications were observed in all patients. CONCLUSION： Erythromycin infusion is effective and safe in improving endoscopic view in patients with acute upper gastrointestinal bleeding.

关 键 词：红霉素 急性上消化道出血 紧急内镜检查 系统评价 META分析 

分 类 号：R573.2[医药卫生—消化系统] R978.15[医药卫生—内科学]