用双气球肠镜进行早期干预,以提高住院患者明显不清晰的胃肠道出血的产量:一种倾向匹配分析
Mahmoud Aryan1, Krishna V R Venkata2, Tyler Colvin1
1Department of Internal Medicine University of Alabama at Birmingham Birmingham Alabama USA.
概括
72小时内出现的双气球肠镜 (DBE) 对于明显的隐形胃肠道出血 (OOGIB) 改善了诊断和治疗产量. 这种早期干预也导致住院患者的胃肠道无出血生存率增加.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 胃肠道出血 胃肠道出血
背景情况:
- 在初始内镜评估后,明显不清晰的胃肠道出血 (OOGIB) 呈现出诊断挑战.
- 视频囊内镜 (VCE) 和双气球肠镜 (DBE) 是小肠检查的关键工具.
- 在住院的OOGIB患者中,DBE的最佳时间仍然是研究领域.
研究的目的:
- 评估早期与非出现的DBE定时对诊断和治疗产量的影响.
- 评估DBE时间对胃肠道 (GI) 再出血率和无GI出血生存率的影响.
- 确定与OOGIB管理中成功的DBE结果相关的因素.
主要方法:
- 在2012年至2020年期间接受DBE的154名住院OOGIB患者的回顾性审查.
- 分层分为突发性 (DBE在72小时内) 和非突发性 (DBE在72小时后) 的组.
- 使用了倾向性得分匹配,逻辑回归和卡普兰-梅尔生存分析.
主要成果:
- 在匹配后,与非出现的DBE (n=56) 相比,出现的DBE (n=56) 与显著更高的诊断和治疗产量有关.
- 接受新兴DBE的患者表现出改善的无胃肠道出血生存率 (P=0.009).
- 之前的VCE是与诊断和治疗收益相关的重要因素.
结论:
- 在住院的OOGIB患者中早期启动DBE可以提高诊断和治疗的成功.
- 及时的DBE干预可以降低胃肠道再出血的速度并改善患者的治疗结果.
- 这些发现支持考虑新出现的DBE,以有效管理OOGIB.
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