在患有乳酸盐水平升高和急性上部胃肠道出血的患者中,内镜的时间;一个回顾性比较研究
Gabriel Allo1, Dilan Gülcicegi1, Johannes Gillessen1
1Department of Gastroenterology and Hepatology, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
Scandinavian journal of gastroenterology
|December 27, 2023
概括
在急性上部胃肠道出血 (AUGIB) 患者中乳酸水平升高并不预测需要紧急内镜检查. 支持建议在复苏后进行非突发性内镜的指导方针.
科学领域:
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
背景情况:
- 目前的指导方针建议在24小时内对急性上部胃肠道出血 (AUGIB) 进行内镜检查,但最佳时间仍在争论中.
- 乳酸盐水平用于医疗紧急情况中的风险分层.
- 这项研究调查了乳酸水平升高是否预测AUGIB患者从即时内镜中受益.
研究的目的:
- 为了评估乳酸盐水平升高的预测值,用于识别急性上部胃肠道出血 (AUGIB) 患者,需要突发性内镜检查.
- 评估AUGIB患者乳酸盐水平与结果之间的关联.
主要方法:
- 从2015年至2019年,对AUGIB患者的回顾性分析,他们患有乳酸水平升高,并出现在急诊室.
- 在6小时内接受突发性内镜 (EE) 和非突发性内镜 (非EE) 的患者之间的结果比较.
主要成果:
- 在134名患者中,81.3%患有显著的并发症 (查尔森指数≥3) 和50.4%患有冲击.
- 随着乳酸盐水平的提高,死亡率增加;11.2%的患者死亡.
- 接受EE患者的血压降低,并接受了更多的输血,但与非EE患者相比,对内镜干预的需要,再出血或死亡率没有显著差异.
结论:
- 这些发现支持目前的指导方针,建议AUGIB患者在初始复苏和并发性疾病管理后进行非突发性内镜检查.
- 在AUGIB患者中乳酸盐水平升高似乎不是对新出现的内镜干预的必要性的可靠指标.
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