下腸出血の現在の管理に関する包括的なレビュー
Shivaraj Afzalpurkar1, Uday C Ghoshal2, Mahesh Kumar Goenka3
1Nanjappa Multi-Speciality Hospitals, Davangere, 577 005, India.
まとめ
下部胃腸出血 (LGIB) は一般的であり,世界的に様々な原因があります. 大腸内視鏡検査は,安定した患者のための主要な診断および治療ツールであり,CT血管図は不安定な症例を助けます.
科学分野:
- 胃腸内科 胃腸内科
- エンドスコピーは,内視鏡検査です.
- 医療診断 医療診断
背景:
- 下部胃腸出血 (LGIB) の定義は進化し,現在,大腸または腸の出血源に焦点を当てています.
- 世界的なLGIB発生率は10万人当たり20.5~87.0であり,死亡率は2.5~3.9%で,再出血率は13~19%である.
- エチオロジーは世界的に異なっています:西側では門出血,インドでは大腸炎とです.
研究 の 目的:
- 急性下部胃腸出血に対する診断および治療アプローチをレビューする.
- LGIB管理におけるコロノスコピーとCTアニオグラフィの役割を強調する.
- 高リスク患者に対する多学科的アプローチを強調する.
主な方法:
- 下部胃腸出血の診断と管理に関する現在の文献のレビュー.
- 血液動力学的に安定した患者の初期診断および治療方法として,大腸内視鏡検査を重視する.
- 不安定な患者または大腸内視鏡検査が失敗したときに,コンピュータートモグラフィー血管図 (CTA) の議論.
主要な成果:
- 大腸内視鏡検査は,クリップの適用や熱凝固などのテクニックを使用して,診断と静止のために有効です.
- CTAは,不安定な患者および,内視静脈静止が成功しない場合において極めて重要です.
- 管理には,抗凝固剤の使用を含め,患者の安定性と併発症を慎重に考慮する必要があります.
結論:
- 大腸内視鏡検査は,安定した患者の急性LGIBの診断と治療の礎石です.
- CTAは,血液動力学的に不安定な患者および耐火性出血の患者にとって不可欠です.
- LGIBの管理には,特に抗凝固剤を服用している患者,または最近心臓ステントを設置した患者の場合,多学科的なアプローチが不可欠です.
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