Department of Clinical Pharmacy, King Abdul-Aziz Medical City, Riyadh, Saudi Arabia.
Gastrointest Endosc. 2011 Feb;73(2):245-50. doi: 10.1016/j.gie.2010.09.043. Epub 2010 Dec 8.
Blood in the stomach and esophagus in patients with variceal bleeding often obscures the endoscopic view and makes endoscopic intervention difficult to perform. Erythromycin, a motilin agonist, induces gastric emptying.
To assess the effect of erythromycin on endoscopic visibility and its outcome in patients with variceal bleeding.
Randomized, double-blind, placebo-controlled trial.
Tertiary care hospital.
Adult patients with liver cirrhosis presenting with hematemesis within the previous 12 hours.
Either 125 mg erythromycin or placebo administered intravenously 30 minutes before endoscopy.
Endoscopic visibility during index endoscopy and mean duration of procedure. SECONDARY OUTCOME MEASUREMENTS: Need for repeat endoscopy and blood transfusions within 24 hours, endoscopy-related complications, and length of hospital stay.
A total of 102 patients received either erythromycin or placebo (53 erythromycin and 49 placebo). Forty-seven patients in the erythromycin group and 43 in the placebo group had variceal bleeding and were considered for final analysis. A completely empty stomach was seen in 48.9% of the erythromycin group versus 23.3% of the placebo group (P<.01). Mean endoscopy duration was significantly shorter in the erythromycin group than in the placebo group (19.0 minutes vs 26.0 minutes, respectively; P<.005). Length of hospital stay was significantly shorter in the erythromycin group than in the placebo group (3.4 days vs 5.1 days, respectively; P<.002). The need for repeat endoscopy and the mean number of units of blood transfused did not differ significantly in the 2 groups. No adverse events were observed with erythromycin.
Sample size not sufficient to measure the need for repeat endoscopy and survival benefit.
Erythromycin infusion before endoscopy in patients with variceal bleeding significantly improves endoscopic visibility and shortens the duration of the index endoscopy. (
NCT01060267.).
患有食管静脉曲张出血的患者胃和食管内的血液常常会使内镜检查的视野模糊，使内镜介入治疗难以进行。红霉素是一种胃动素激动剂，可诱导胃排空。
评估红霉素对食管静脉曲张出血患者内镜可视性及其结果的影响。
随机、双盲、安慰剂对照试验。
三级护理医院。
患有肝硬化的成年患者，呕血发生在过去 12 小时内。
在进行内镜检查前 30 分钟静脉内给予 125 毫克红霉素或安慰剂。
索引内镜检查期间的内镜可视性和程序的平均持续时间。次要观察指标：24 小时内需要重复内镜检查和输血、内镜相关并发症以及住院时间。
共有 102 名患者接受了红霉素或安慰剂治疗（红霉素 53 例，安慰剂 49 例）。在红霉素组和安慰剂组中，有 47 例和 43 例患者患有食管静脉曲张出血，被纳入最终分析。红霉素组完全排空的胃占 48.9%，而安慰剂组仅占 23.3%（P<.01）。红霉素组的内镜检查平均持续时间明显短于安慰剂组（分别为 19.0 分钟和 26.0 分钟；P<.005）。红霉素组的住院时间明显短于安慰剂组（分别为 3.4 天和 5.1 天；P<.002）。两组之间重复内镜检查的需求和平均输血量没有明显差异。红霉素未观察到不良反应。
样本量不足以衡量重复内镜检查的需求和生存获益。
在食管静脉曲张出血患者中，内镜检查前给予红霉素静脉注射可显著提高内镜可视性，并缩短索引内镜检查的持续时间。（临床试验注册号：NCT01060267.）。
