影响转动脉栓塞后再出血的因素 对于内镜无法控制的胃潰瘍出血
Ji Hoon Yu1, Jeong Woo Lee1, Jun-Young Seo1
1Division of Gastroenterology, Department of Internal Medicine, Bundang Jesaeng General Hospital, Gyeonggi-do, Republic of Korea.
Scandinavian journal of gastroenterology
|September 6, 2023
概括
超动脉内脏栓塞 (TAE) 是治疗胃出血的救援疗法. 经过TAE后的重出血与血小板数量低和大小有关,突出了这种干预的关键风险因素.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 血管外科 血管外科
背景情况:
- 急性胃潰瘍出血是非狀上部胃腸出血 (NVUGIB) 的常見原因.
- 内镜血静是标准的,但并发症需要替代治疗.
- 超动脉内脏栓塞 (TAE) 是耐火病例的关键救援疗法.
研究的目的:
- 在患有胃潰瘍出血的患者中,在跨動脈內臟栓塞 (TAE) 后預測再出血的因素.
- 评估TAE作为NVUGIB的救援疗法的有效性.
主要方法:
- 对156名接受TAE治疗的患者进行了性出血的回顾性分析 (2007年1月至2021年12月).
- 再出血是由临床症状 (黑斑,血凝,血) 和血动力学妥协 (血红蛋白下降或休克) 所定义的.
- 多变量逻辑回归用于确定再出血的预测因素.
主要成果:
- 在70名患者中,有15名患者 (21.4%) 在TAE后一个月内再次出血.
- 血小板缺血 (73.3%对16.4%) 和大小>1厘米 (93.3%对54.5%) 在复出血组中明显更为普遍.
- 较高的平均AIMS65分数 (2.3对1.4) 和特定因素,如血小板缺血 (OR 31.92) 和大尺寸 (OR 27.19) 独立预测出血.
结论:
- 超动脉内脏栓塞 (TAE) 是有效的高风险的胃出血.
- 血小板缺血和较大的大小是TAE后再次出血的重要独立预测因素.
- 在TAE之后,AIMS65评分是重出血风险的有价值预测指标.
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