在结肠镜检查期间脏损伤的脏动脉栓塞:系统性审查
Matthew Lukies1, Warren Clements1,2,3
1Department of Radiology, Alfred Health, Melbourne, Victoria, Australia.
United European gastroenterology journal
|December 4, 2023
概括
动脉栓塞是结肠镜相关的脏损伤的有效治疗方法,提供脏的保存和可比性死亡率与切除术. 这种最少的侵入性方法应考虑适合患者,增强结果和维护免疫功能.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 创伤外科 手术 创伤外科
背景情况:
- 结肠镜检查造成的脏损伤很少见,但存在高死亡风险.
- 传统的治疗方法包括保守的管理或脊髓切除术.
- 动脉栓塞 (SAE) 正成为一种可行的替代方案,符合创伤护理指南.
研究的目的:
- 系统地审查由SAE治疗的结肠镜引起的脏损伤的结果.
- 为了比较SAE与传统的治疗方法,如脊髓切除术和脊髓炎.
主要方法:
- 从1977年到2022年发表的文学作品的系统审查.
- 包括在结肠镜检查期间与SAE治疗的脊髓损伤病例,脊髓切除术或脊髓异常.
- 收集有关患者人口统计,损伤等级,治疗和结果的数据,包括死亡率和脏保存.
主要成果:
- 在30名患者中使用SAE,其中83%的患者避免了脊髓切除术,死亡率为6.7%.
- 163名患者进行了切除术,死亡率为5.5%.
- 在SAE和脊髓切除队列之间没有观察到死亡率的显著差异 (p=0.81).
结论:
- 动脉栓塞是结肠镜诱导的脏损伤的有效治疗方法.
- SAE促进了脏的保存,提供了诸如维持免疫功能和更短的住院时间等好处.
- 应将SAE纳入符合条件的结肠镜相关的脏损伤患者的治疗方案.
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