咖啡粉吐和早期内镜检查:时间是否真的很重要?
Ignacio Blanco Nodal1, Valentín Roales Gómez1, David Olivares Quintanar2
1Servicio de Aparato Digestivo, Hospital Clínico San Carlos, Madrid, España.
概括
咖啡粉吐本身并不是上部胃肠道出血的可靠指标. 紧急内镜没有提供生存益处,建议采取保守的方法.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 咖啡粉吐是上胃肠道出血的一个公认症状.
- 它的临床实用性受到低积极预测值的限制.
- 紧急内镜对患者结果的影响需要进一步调查.
研究的目的:
- 评估紧急内镜是否会改变治疗管理,并影响咖啡粉吐患者的存活率.
- 评估咖啡粉吐作为上部胃肠道出血的指标的临床有用性.
主要方法:
- 对因咖啡粉吐而接受胃镜检查的患者进行了回顾性,观察性和描述性研究 (2017-2021).
- 紧急 (24小时内) 和预定 (24小时后) 内镜组之间的结果比较.
- 分析包括生存率,ICU入院,住院时间和再出血率.
主要成果:
- 紧急和计划内镜组之间在ICU入院,住院日数,存活率或30天再出血方面没有发现显著差异.
- 在两组中,确定的出血病变的数量和治疗内镜的需要是相似的.
- 包括276名患者 (176名紧急,109名预定).
结论:
- 咖啡粉吐,单独来说,是上胃肠道出血的不可靠指标.
- 紧急内镜检查并不能改善患有这种症状的患者的死亡率.
- 保守的内镜策略可以降低风险和成本,而不会影响患者的预后.
相关概念视频
Endoscopic Procedures I: Esophagogastroduodenoscopy
138
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
138
Endoscopic Procedures III: Video Capsule Endoscopy
172
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
172
Endoscopic Procedures V: ERCP
311
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
311
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
99
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
99
Lower GI Series: Barium Enema
303
A Barium Enema, or a lower GI series, is a specialized radiographic examination designed to visualize the lower gastrointestinal tract, specifically the colon and rectum. This procedure is instrumental in diagnosing various conditions such as colorectal cancer, polyps, diverticulosis, and inflammatory bowel disease.
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
303
Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
95
This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
95


