上部胃肠道泄漏和穿孔的内镜真空治疗:来自西班牙多中心注册表的分析
Dulce Momblan1, Antonio Z Gimeno Garcia2, David Busquets3
1Department of Gastrointestinal Surgery, Hospital Clínic de Barcelona, Barcelona, Spain.
The American journal of gastroenterology
|August 22, 2023
概括
内镜真空疗法 (EVT) 有效地关闭上部胃肠道缺陷,成功率为82%. 早期干预是关键,因为延迟治疗会增加EVT衰竭和死亡的风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 治疗内镜治疗内镜
背景情况:
- 内镜真空治疗 (EVT) 是一种新兴的技术,用于管理上部胃肠道 (UGI) 缺陷.
- 现有证据仅限于小型,单中心的回顾性研究.
- 影响EVT成功和失败的因素需要进一步调查.
研究的目的:
- 在多中心环境中评估EVT对UGI缺陷的有效性和安全性.
- 为了确定EVT故障的预测因素.
- 确定与EVT后医院死亡率相关的因素.
主要方法:
- 涉及19家西班牙医院的前性队列研究.
- 包含在国家注册表中记录的连续EVT程序 (2018年11月 - 2022年3月).
- 分析了102名患有静脉漏或穿孔的患者.
主要成果:
- 在82%的患者 (84/102) 中成功关闭缺陷.
- 在5.9%的患者中发生了不良事件;住院死亡率为12.7%.
- 延迟EVT启动是EVT失败的唯一独立预测因素 (OR1.03,P=0.005);EVT失败和EVT后肺炎预测死亡率.
结论:
- EVT证明了对上部消化道的解静脉性泄漏和穿孔的安全性和有效性.
- 及时启动EVT对于最大限度地提高治疗成功至关重要.
- 早期使用 EVT 改善了管理 UGI 缺陷的结果.
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