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经皮冠状动脉介入治疗后胃肠道出血风险及保护因素的荟萃分析。

Meta-analysis of risk and protective factors for gastrointestinal bleeding after percutaneous coronary intervention.

作者信息

Wang Lan, Pei Dajun, Ouyang Yan-Qiong, Nie Xiaofei

机构信息

School of Health Sciences of Wuhan University, Wuhan, China.

Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Int J Nurs Pract. 2019 Feb;25(1):e12707. doi: 10.1111/ijn.12707. Epub 2018 Nov 19.

Abstract

AIM

To quantitatively analyse factors related to gastrointestinal bleeding after percutaneous coronary intervention and provide evidence for the prevention of gastrointestinal bleeding.

DATA SOURCES AND REVIEW METHODS

Cochrane Library, Pubmed, Embase, and Ovid databases were searched from inception to 31 May 2018; case-control and cohort studies published in English were included. The methodological quality of each study was assessed by two independent reviewers using the Newcastle-Ottawa Scale. Meta-analysis was performed using Revman version 5.3.

RESULTS

A total of 16 publications yielded data about risk factors. It was found that age older than 70 years, age (per 10-year increase), female sex, baseline anaemia, history of smoking, history of using alcohol, history of peptic ulcer disease, chronic renal failure, previous bleeding, shock, congestive heart failure, acute myocardial infarction, prior use of inotropic medications, and prior use of antithrombotic medications were positively associated with gastrointestinal bleeding. Four articles yielded data about protective factors. It was found that proton-pump inhibitor and bivalirudin therapy were negatively associated with gastrointestinal bleeding after percutaneous coronary intervention.

CONCLUSION

This research found risk and protective factors which can assist in effective management of this potentially fatal complication.

摘要

目的

定量分析经皮冠状动脉介入治疗后胃肠道出血的相关因素,为预防胃肠道出血提供依据。

资料来源与检索方法

检索Cochrane图书馆、Pubmed、Embase和Ovid数据库,检索时间从建库至2018年5月31日;纳入以英文发表的病例对照研究和队列研究。由两名独立评价员使用纽卡斯尔-渥太华量表对每项研究的方法学质量进行评估。使用Revman 5.3版进行荟萃分析。

结果

共有16篇出版物提供了关于危险因素的数据。结果发现,年龄大于70岁、年龄每增加10岁、女性、基线贫血、吸烟史、饮酒史、消化性溃疡病史、慢性肾功能衰竭、既往出血史、休克、充血性心力衰竭、急性心肌梗死、既往使用正性肌力药物以及既往使用抗血栓药物与胃肠道出血呈正相关。4篇文章提供了关于保护因素的数据。结果发现,质子泵抑制剂和比伐卢定治疗与经皮冠状动脉介入治疗后胃肠道出血呈负相关。

结论

本研究发现了风险因素和保护因素,有助于对这种潜在致命并发症进行有效管理。

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