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目的:采用Meta分析方法评价质子泵抑制剂(PPI)静脉不同给药方式对消化道溃疡出血患者预后的影响,期望为消化道溃疡出血患者PPI给药方式的选择提供证据。方法:计算机检索Pub Med、Embase、The Cochrane Library、Clinicaltrials.gov、CNKI、Wanfang Data、Sino Med,检索时间限定为建库至2017年1月,搜集有关PPI静脉不同给药方式对消化道溃疡所致出血患者治疗效果的随机对照试验。采用Rev Man 5.3软件进行Meta分析。结果:本研究纳入17篇RCT,共3 033例患者。Meta分析结果显示,消化道溃疡出血患者静脉持续输注与间歇输注PPI相比,再出血发生率(RR=0.82,95%CI:0.62~1.08,P=0.16),手术例数(RR=0.99,95%CI:0.62~1.57,P=0.97),死亡率(RR=0.67,95%CI:0.31~1.43,P=0.30)的差异无统计学意义。结论:消化道溃疡出血患者,静脉间歇给予PPI治疗与持续输注可达到相同的疗效。
OBJECTIVE: To evaluate the effect of different modes of intravenous administration of proton pump inhibitor (PPI) on the prognosis of patients with peptic ulcer hemorrhage by meta-analysis, and to provide evidence for the selection of PPI administration mode in patients with peptic ulcer bleeding. METHODS: PubMed, Embase, The Cochrane Library, Clinicaltrials.gov, CNKI, Wanfang Data and SinoMed were searched by computer. The search time was limited to establishing a database from January 2017 to January, A randomized controlled trial of the therapeutic effect of bleeding in patients. Meta-analysis was performed using Rev Man 5.3 software. Results: 17 RCTs were included in this study, with a total of 3 033 patients. The results of Meta analysis showed that the rate of rebleeding (P = 0.16, RR = 0.82, 95% CI: 0.62-1.08, P = 0.16), the number of cases of surgery (RR = 0.99, 95% CI: 0.62-1.57, P = 0.97). There was no significant difference in mortality (RR = 0.67,95% CI: 0.31-1.43, P = 0.30). Conclusion: Patients with peptic ulcer bleeding, intravenous intermittent PPI treatment and continuous infusion can achieve the same effect.