使用抗凝剂的患者的急性非静脉上胃肠道出血:内镜的时间是否会影响结果?
Tiago Lima Capela1,2,3, Vítor Macedo Silva4,5,6, Marta Freitas4,5,6
1Gastroenterology Department, Hospital da Senhora da Oliveira, Rua Dos Cutileiros, Creixomil, 4835-044, Guimarães, Portugal. tiagolimacapela@gmail.com.
Digestive diseases and sciences
|December 20, 2023
概括
在服用抗凝剂的患者中,在24小时内对急性上部胃肠道出血进行早期内镜检查,导致更多的内镜治疗和更短的住院时间. 这种时间不会影响死亡率或复发出血率.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 急性非静脉上胃肠道出血 (NVUGIB) 管理指南建议在复苏后进行早期内镜检查 (≤24小时).
- 对服用抗凝剂的NVUGIB患者进行内镜的最佳时间仍未得到充分研究.
研究的目的:
- 调查内镜时间对服用抗凝血药物的NVUGIB患者的结果的影响.
主要方法:
- 成年NVUGIB患者服用抗凝固剂的回顾性队列研究 (2011年1月至2020年6月).
- 内镜定时分类为早期 (≤24小时) 或延迟 (>24小时).
- 分析结果:治疗,住院,ICU入院,再出血和30天死亡率.
主要成果:
- 早期内镜检查 (≤24小时) 与内镜治疗增加 (OR 2.4) 和住院时间缩短 (7 vs 9天) 相联系.
- 接受早期内镜检查的患者的中期/重症监护病房入院率更高 (OR 2.7).
- 在早期和延迟内镜组之间没有观察到手术治疗,复发出血或30天死亡率的显著差异.
结论:
- 在使用NVUGIB抗凝剂的患者中,早期内镜 (≤24小时) 与更高的内镜治疗率和更短的住院时间相关.
- 在这个患者队列中,内镜时间没有显著影响手术干预的需要,复发性出血或30天死亡率.
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