Vitamin K for upper gastrointestinal bleeding in patients with liver diseases

 

Abstract

Background

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Several treatments are used for upper gastrointestinal bleeding in patients with liver diseases. One of them is vitamin K administration, but it is unknown whether it benefits or harms patients with liver disease and upper gastrointestinal bleeding.

Objectives

To assess the beneficial and harmful effects of vitamin K for patients with liver disease and upper gastrointestinal bleeding.

Search methods

We searched The Cochrane Hepato-Biliary Group Controlled Trials Register (September 2007), which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 3, 2007), MEDLINE (1950 to September 2007), EMBASE (1980 to September 2007), Science Citation Index Expanded (1945 to September 2007), and LILACS (1982 to November 2007). Additional randomised trials were sought from two registries of clinical trials, ClinicalTrials.gov and Sistema de Información Esencial en Terapéutica y Salud, the reference lists of the trials found, and reviews identified by the electronic searches.

Selection criteria

Randomised clinical trials.

Data collection and analysis

Data from randomised clinical trials were to be summarised by standard Cochrane Collaboration methodologies.

Main results

We could not find any randomised trials on vitamin K for upper gastrointestinal bleeding in patients with liver diseases.

Authors' conclusions

This updated review found no randomised clinical trials on the safety and efficacy of vitamin K for upper gastrointestinal bleeding in patients with liver diseases. The effects of vitamin K need to be tested in randomised clinical trials. Unless randomised clinical trials provide evidence of a treatment effect and the trade off between potential benefits and harms are established, policy-makers, clinicians, and academics should not use vitamin K for upper gastrointestinal bleeding in patients with liver diseases.

 

Plain language summary

There is no evidence to establish the beneficial or harmful effects of vitamin K for upper gastrointestinal bleeding in patients with liver diseases

Upper gastrointestinal bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. Vitamin K administration is used as a supplementary intervention, but it is unknown whether it benefits or harms patients with liver disease and upper gastrointestinal bleeding. This updated review found no randomised clinical trials on the safety and efficacy of vitamin K for upper gastrointestinal bleeding in patients with liver diseases.

 

摘要

背景

維生素K治療肝臟疾病病患的上腸胃道出血

上腸胃道出血是肝硬化的病程中最常見導致罹病和死亡的原因之一。有數種治療已用於肝臟疾病合併上腸胃道出血的病患。不過，附加性的治療也經常被使用。其中之一就是給予維生素K，但是不知道維生素K對於患有肝臟疾病合併上腸胃道出血的病患有助益或是有危害。

目標

評估維生素K對於患有肝臟疾病合併上腸胃道出血的病患有利和有害的效應。

搜尋策略

我們搜尋Cochrane HepatoBiliaryGroup Controlled Trials Register (2004年2月)，其包括從綜合性電子資料庫搜尋和手工尋找相關性期刊的參考文獻以及學術會議的摘要書。我們也搜尋在考科藍圖書館的CENTRAL(2004年，第1期), MEDLINE(1966年到2004年3月)， EMBASE(1988年到2004年3月)，以及LILACS(1982年到2004年3月)的資料。並從電腦搜尋找到的試驗的參考文獻清單和搜尋到的回顧性文章，中尋找到額外的隨機試驗的。

選擇標準

我們打算涵括隨機性臨床試驗。

資料收集與分析

我們欲透過標準的考科藍合作組織方法學來總結數據

主要結論

我們找不到任何關於維生素K應用於肝臟疾病合併上腸胃道出血病患的隨機性臨床試驗。

作者結論

我們無法確定維生素K對於肝臟疾病合併上腸胃道出血病患的安全和效力。需要隨機臨床試驗以測試維生素K的效力。

翻譯人

本摘要由臺中榮民總醫院王建得翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

缺乏有力的證據說明維生素K於患有肝臟疾病病患所導致的上腸胃道出血之有利或有害的效應。我們找不到維生素K用於患有肝臟疾病合併上腸胃道出血病患的隨機性試驗。缺乏有力的證據支持或反對肝臟疾病病患使用維生素K。