Division of Gastroenterology and Hepatology, CE405, DC 043.00, University of Missouri Health Sciences Center, Five Hospital Drive, Columbia, MO 65212, USA.
Saudi J Gastroenterol. 2013 Sep-Oct;19(5):205-10. doi: 10.4103/1319-3767.118120.
BACKGROUND/AIM: Erythromycin infusion before endoscopy in upper gastrointestinal bleeding (UGIB) has been hypothesized to aid in visualization and reduce the need for second-look endoscopy; however, the results have been controversial. To evaluate further, we performed a meta-analysis comparing the efficacy of erythromycin infusion before endoscopy in acute UGIB.
Multiple databases were searched (March 2013). Only randomized controlled trials were included in the analysis. A meta-analysis for the effect of erythromycin or no erythromycin before endoscopy in UGIB were analyzed by calculating pooled estimates of primary (visualization of gastric mucosa and need for second endoscopy) and secondary (units of blood transfused, length of hospital stay, duration of the procedure) outcomes. Statistical analysis was performed using RevMan 5.1 (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration).
Six studies (N = 558) met the inclusion criteria. Erythromycin infusion before endoscopy in UGIB demonstrated a statistically significant improvement in visualization of the gastric mucosa [odds ratio (OR) 3.43; 95% confidence interval (CI): 1.81 to 6.50, P < 0.01] compared with no erythromycin. In addition, erythromycin infusion before endoscopy resulted in a statistically significant decrease in the need for a second endoscopy (OR 0.47; 95% CI: 0.26 to 0.83, P = 0.01), units of blood transfused (WMD - 0.41; 95% CI: -0.82 to -0.01, P = 0.04), and the duration of hospital stay (WMD - 1.51; 95% CI: -2.45 to -0.56, P < 0.01).
Erythromycin infusion before endoscopy in patients with UGIB significantly improves visualization of gastric mucosa while decreasing the need for a second endoscopy, units of blood transfused, and duration of hospital stay.
背景/目的：在胃镜检查前输注红霉素被假设可以帮助观察并减少再次进行内镜检查的需要，但结果一直存在争议。为了进一步评估，我们进行了荟萃分析，比较了胃镜检查前输注红霉素治疗急性上消化道出血（UGIB）的疗效。
检索多个数据库（2013 年 3 月）。只有随机对照试验被纳入分析。通过计算主要（胃黏膜的可视化和再次内镜检查的需要）和次要（输血量、住院时间、手术持续时间）结局的汇总估计值，对接受或不接受红霉素的 UGIB 患者进行内镜检查的效果进行荟萃分析。统计分析使用 RevMan 5.1（哥本哈根：北欧 Cochrane 中心，Cochrane 协作网）进行。
符合纳入标准的有 6 项研究（N=558）。与不使用红霉素相比，在 UGIB 中，胃镜检查前输注红霉素可显著改善胃黏膜的可视化[比值比（OR）3.43；95%置信区间（CI）：1.81 至 6.50，P<0.01]。此外，红霉素输注前的内镜检查还可显著降低再次内镜检查的需要（OR 0.47；95%CI：0.26 至 0.83，P=0.01）、输血量（WMD-0.41；95%CI：-0.82 至-0.01，P=0.04）和住院时间（WMD-1.51；95%CI：-2.45 至-0.56，P<0.01）。
在 UGIB 患者中，胃镜检查前输注红霉素可显著改善胃黏膜的可视化，同时减少再次内镜检查、输血量和住院时间的需要。
