精确地应用局部特兰胺酸来增强胃出血的内镜血静:一项随机对照研究 (附视频)
Hsueh-Chien Chiang1, Po-Jun Chen2, Er-Hsiang Yang2
1Department of Internal Medicine, National Cheng Kung University Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Gastrointestinal endoscopy
|June 25, 2023
概括
在内静止期间应用的局部素酸 (TXA) 粉末显著减少了胃潰瘍患者的复发出血. 这种增强的血液静止策略改善了结果,为治疗出血提供了一种有前途的新方法.
科学领域:
- 胃肠病学 胃肠病学
- 内镜血液静止症 (endoscopic hemostasis) 是一种内镜血液静止症.
- 药理学 药理学是指药理学的学科.
背景情况:
- 胃潰瘍反復出血會影響20-30%的患者在血停後.
- 标准内镜血静有限制在防止再次出血.
- 局部使用的松酸 (TXA) 可能会提高血静效率.
研究的目的:
- 为了研究局部TXA粉末在提高出血性胃的血液静止的有效性.
- 评估TXA对早期治疗失败率的影响.
- 评估TXA在内镜手术过程中的安全性.
主要方法:
- 随机对照试验涉及60名患有胃出血的患者.
- 患者接受标准内镜治疗,然后随机分配TXA粉末或标准护理.
- TXA组通过内镜接受了1.25g的TXA粉末;两组都接受了PPI输液.
- 第二次内镜评估治疗失败在4天内.
主要成果:
- 早期治疗失败率在TXA组 (6.7%) 与标准组 (30%) 相比显著较低 (P=0.042).
- 在TXA组 (P=0.023) 中,没有治疗失败的时间显著长达4天和28天.
- 没有报告与TXA应用相关的不良事件.
结论:
- 在内镜血静止期间局部TXA应用有效地减少了胃患者的早期再出血率.
- 这种辅助疗法增强了血液静止,改善了患者的结果.
- TXA粉是标准内镜治疗出血性胃的安全有效补充剂.
相关概念视频
Peptic Ulcer Disease IV: Management
115
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
115
Anticoagulant Drugs: Low-Molecular-Weight Heparins
763
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
763
Esophageal Varices-II: Clinical Features and Management
99
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
99
Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
508
The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
508
Venous Thrombosis III: Interprofessional Care
11
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
11
Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
567
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
567


