中国作者重要发表 - 制酸剂用于胃食道静脉曲张出血和肝硬化再次出血的预防



制酸剂用于胃食道静脉曲张出血和肝硬化再次出血的预防





Antacids for preventing oesophagogastric variceal bleeding and rebleeding in cirrhotic patients





Yang J., Guo Z., Wu Z., Wang Y. 2009/5/29 18:39:20

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Cochrane Database of Systematic Reviews, 2008, Volume 0, Issue 2




Background: Ruptured gastroesophageal varices are the most severe and frequent cause of gastrointestinal bleeding in cirrhotic patients, leading to death in 5% to 8% of patients during the first 48 hours and oesophagogastric varices account for 60% to 80% of first bleeding in patients with portal hypertension. Antacids are often used for emergency treatment of bleeding oesophageal varices in patients with cirrhosis of the liver. Objectives: To evaluate the beneficial and harmful effects of antacids for preventing oesophagogastric bleeding and rebleeding. Search strategy: We identified relevant randomised clinical trials by searching The Cochrane Hepato-Biliary Group Controlled Trials Register (June 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2007), MEDLINE (1950 to June 2007), EMBASE (Excerpta Medica Database) (1980 to June 2007), and the Science Citation Index Expanded (SCI-EXPANDED) (1945 to June 2007). Additional randomised trials were sought from the reference lists of the trials found and reviews identified by the electronic searches. Selection criteria: We planned to include randomised clinical trials. Data collection and analysis: We planned to summarise data using Cochrane Collaboration methodologies. Main results: We could not find any randomised clinical trials on antacids for preventing oesophagogastric variceal bleeding and bleeding in cirrhotic patients. Authors' conclusions: it is not possible to determine whether antacids are beneficially effective or harmful for preventing oesophagogastric variceal bleeding and rebleeding in cirrhotic patients since randomised clinical trials investigating it are lacking. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.



Correspondence Address: Wang, Y.; Gastrointestinal Department, West China Hospital, Sichuan University, Guoxuexiang 37, Chengdu 610041, China; email: wyplm@mail.sc.cninfo.net



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高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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