上消化道出血内镜检查前输注阿奇霉素与红霉素。

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2022-10-25 eCollection Date: 2022-01-01 DOI:10.21037/tgh-20-51
Danny Issa, Sanjeev Solomon, Jonathan Hillyard, Brian Di Pace, Christopher Young, Patricia Uber, Adam Sima, Reem Sharaiha, George Smallfield
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引用次数: 2

摘要

背景:上消化道出血(GIB)内镜检查前静脉注射红霉素可改善预后,但需要立即准备,延迟急诊病例给药。阿奇霉素容易获得,不需要长时间制备。本研究的目的是评估阿奇霉素与红霉素相比,在改善上GIB内镜显示质量方面的效果。方法:纳入急诊内镜检查前接受红霉素或阿奇霉素治疗的上GIB患者。可视化质量的主要结果由两名胃肠病学家评估,他们不知道输注方式的选择,使用评分系统从0到8,眼底、体、胃窦和球最多2分。结果:纳入66例患者;阿奇霉素25例,红霉素41例。阿奇霉素组的平均总可视化评分显著高于红霉素组(分别为6.8±1.4分和5.5±2.2分);P=0.01),调整混杂因素后仍然显著(差异:0.01,1.88;P = 0.05)。次要结局分析显示,与红霉素相比,给予阿奇霉素的LOS更短[分别为6(3至9)天和8(7至16)天,95% CI: 1.03, 3.89;P = 0.04)。阿奇霉素组从开始输注到内镜检查的时间较长(Diff: 40.64 min;95% ci: 7.23, 74.05;P = 0.02)。两组间复查内镜、手术时间、输血需求和手术相关并发症均无差异。结论:上GIB内镜检查前输注阿奇霉素比红霉素有更好的视觉效果。需要随机试验来验证这些发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Azithromycin versus erythromycin infusions prior to endoscopy in upper gastrointestinal bleeding.

Background: Intravenous erythromycin prior to endoscopy for upper gastrointestinal bleeding (GIB) improves outcomes but requires immediate preparation delaying administration in emergency cases. Azithromycin is readily available and does not require prolonged preparation. The aim of the study was to assess the effect of azithromycin in improving the quality of endoscopic visualization in upper GIB compared to erythromycin.

Methods: Patients admitted with upper GIB who received erythromycin or azithromycin before urgent endoscopy were included. Primary outcome of the quality of visualization was assessed by two gastroenterologists, blinded to the choice of infusion, using a scoring system ranging from 0 to 8, with a maximum of 2 points assigned to the fundus, body, antrum and bulb.

Results: Sixty-six patients were included; 25 received azithromycin and 41 received erythromycin. Mean total visualization score was significantly higher with azithromycin compared to that with erythromycin (6.8±1.4 vs. 5.5±2.2, respectively; P=0.01) and remained significant after adjusting for confounders (Diff: 0.01, 1.88; P=0.05). Secondary outcomes analyses showed a shorter LOS when given azithromycin compared to erythromycin [6 (3 to 9) vs. 8 (7 to 16) days, respectively, 95% CI: 1.03, 3.89; P=0.04]. Time between initiating the infusion and endoscopy was longer with azithromycin (Diff: 40.64 min; 95% CI: 7.23, 74.05; P=0.02). Need for second look endoscopy, procedure time, blood transfusion requirements and procedure-related complications did not differ between the groups.

Conclusions: Azithromycin infusion before endoscopy for upper GIB was associated with better visualization than that of erythromycin. Randomized trials are needed to validate these findings.

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来源期刊
CiteScore
8.20
自引率
0.00%
发文量
1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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