胃潰瘍出血中的多普勒導向第二檢視內視鏡:一個隨機對照試驗
Michael Milek Nielsen1, Ove B Schaffalitzky de Muckadell1,2, Stig Borbjerg Laursen1,2
1Department of Gastroenterology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark.
使用多普勒内镜探针 (DEP) 检查胃出血 (PUB) 的二次内镜是安全的,并且显示出低的复出血率. 这种方法可能有利于高风险患者,为首次使用DEP提供了替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 多普勒内镜探针 (DEP) 可能改善胃出血 (PUB) 的结果.
- 在初始内镜检查期间,可能无法获得DEP评估能力.
- 这项研究调查了PUB的第二次内镜对DEP的评估.
研究的目的:
- 在患有胃潰瘍出血的患者中,以DEP評估評估第二檢視內視鏡的結果.
- 评估二次内镜中DEP导向治疗的安全性和有效性.
- 为了比较DEP引导的二次内镜和标准治疗之间的再出血率.
主要方法:
- 一个随机对照试验,比较二次观察内镜与DEP评估与标准治疗.
- 患有Forrest Ia-IIb胃潰瘍的患者,最初接受了內視鏡治療,被隨機分配.
- 主要结局是30天内再次出血;次要结局包括输血,住院和死亡率.
主要成果:
- 在DEP组中发生了一次再出血事件 (3%),而在对照组中发生了四次 (13%) (p=0.20).
- 在DEP评估中,发现91%的患者有积极信号,导致进一步进行内镜治疗.
- 在二次结果中没有观察到显著差异,DEP评估是安全的.
结论:
- 用DEP评估进行二次内镜对PUB患者来说是安全的,显示出非常低的再出血风险.
- 这种策略可以考虑在选择的高风险PUB患者中作为首次DEP使用的替代方案.
- 与标准护理相比,该研究没有发现患者整体结果的统计学上显著改善.
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