在阴性囊内镜检查后,患有不明显的胃肠道出血的患者的长期结果
Issei Hirata1, Akiyoshi Tsuboi1, Yuka Matsubara1
1Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Journal of gastroenterology and hepatology
|October 14, 2023
概括
患有模糊的胃肠道出血 (OGIB) 和阴性囊内镜 (CE) 发现的患者 (P0) 很少从小肠重新出血. 那些有P1 CE发现或内镜血静史的人需要密集的随访,以防再出血的风险.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 消化系统疾病 消化系统疾病
背景情况:
- 小肠囊内镜 (CE) 对于诊断不明的胃肠道出血 (OGIB) 是至关重要的.
- 在OGIB患者中阴性CE后的长期结果尚未确定.
- P分类系统将CE发现分为P0 (没有出血潜力) 和P1 (不太可能出血).
研究的目的:
- 为了澄清OGIB患者在负CE后的长期结果.
- 根据CE发现 (P0与P1) 来评估再出血率.
- 在OGIB患者中确定小肠再出血的预测因素.
主要方法:
- 一个单一中心的观察性研究包括461名连续的OGIB患者接受CE.
- 患者被跟踪了一年多,以评估再出血率.
- 多变量分析确定了小肠再出血的独立预测因素.
主要成果:
- 49%的患者有P0发现,51%的患者有P1发现.
- 再生率为P0的9%和P1.1的16%.
- 小肠再出血发生在P0患者的1%和P1患者的6% (P=0.002).
- 内镜血静史和P1 CE发现独立预测了小肠再出血.
结论:
- 有P0CE发现的OGIB患者小肠再出血的风险较低.
- 患有小肠病变或P1 CE发现的内镜血静史的患者需要进行密集的随访.
- 重出血是OGIB患者潜在的长期并发症.
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