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首页> 外文期刊>Gastrointestinal Endoscopy >Effect of erythromycin before endoscopy in patients presenting with variceal bleeding: a prospective, randomized, double-blind, placebo-controlled trial.
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Effect of erythromycin before endoscopy in patients presenting with variceal bleeding: a prospective, randomized, double-blind, placebo-controlled trial.

机译：内镜检查前红霉素对曲张静脉出血患者的影响：一项前瞻性，随机，双盲，安慰剂对照试验。

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BACKGROUND: 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. OBJECTIVE: To assess the effect of erythromycin on endoscopic visibility and its outcome in patients with variceal bleeding. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Tertiary care hospital. PATIENTS: Adult patients with liver cirrhosis presenting with hematemesis within the previous 12 hours. INTERVENTION: Either 125 mg erythromycin or placebo administered intravenously 30 minutes before endoscopy. MAIN OUTCOME MEASUREMENTS: 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. RESULTS: 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. LIMITATIONS: Sample size not sufficient to measure the need for repeat endoscopy and survival benefit. CONCLUSIONS: Erythromycin infusion before endoscopy in patients with variceal bleeding significantly improves endoscopic visibility and shortens the duration of the index endoscopy. (Clinical trial registration number: NCT01060267.).
机译：背景：静脉曲张破裂出血患者的胃和食道中的血液常常使内窥镜视线模糊，并使内窥镜干预难以执行。胃动素激动剂红霉素引起胃排空。目的：评估红霉素对静脉曲张破裂出血患者的内镜可见性及其预后的影响。设计：随机，双盲，安慰剂对照试验。地点：三级医院。患者：成年的肝硬化患者在过去的12小时内出现呕血。干预：内镜检查前30分钟静脉注射125 mg红霉素或安慰剂。主要观察指标：指标内窥镜检查过程中的内窥镜检查可见度和平均手术时间。二级结果测量：需要在24小时内重复进行内窥镜检查和输血，内窥镜检查相关的并发症以及住院时间。结果：总共102例患者接受了红霉素或安慰剂治疗（53例红霉素和49例​​安慰剂）。红霉素组的47例患者和安慰剂组的43例患者发生了曲张静脉曲张破裂出血，并考虑进行最终分析。在红霉素组中，有48.9％的人发现胃完全空，而在安慰剂组中则为23.3％（P <0.01）。红霉素组的平均内窥镜检查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）。在两组中，对重复内窥镜检查的需要和输血的平均单位数没有显着差异。红霉素未观察到不良反应。局限性：样本量不足以测量重复内窥镜检查和生存获益的必要性。结论：曲张静脉出血患者内镜检查前输注红霉素可显着改善内窥镜能见度并缩短指数内窥镜检查的时间。 （临床试验注册号：NCT01060267。）。

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