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刺切除术后延迟出血:静血粉是一种安全有效的选择
Mara Sarmento Costa1, Andrea Silva2, Luís Santos2
1Gastroenterology , Centro Hospitalar e Universitário de Coimbra, Portugal.
Revista espanola de enfermedades digestivas
|January 11, 2024
概括
本案例研究强调了在患有胆结石和胆结炎的患者中管理ERCP后出血的方法. 静血粉在内镜干预后成功控制了持续性出血.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术 进行内镜手术
- 肝胆道疾病 肝胆道疾病
背景情况:
- 急性胆道炎是一种严重的胆道感染,通常需要内镜干预.
- 内镜逆行胆血管细胞造影 (ERCP) 是一种常见的治疗胆道结石的方法,但随之而来的风险包括神经切术后出血等.
- 在ERCP后管理耐火性出血可能具有挑战性.
研究的目的:
- 展示一个管理ERCP后显著出血的案例.
- 为了评估血液静止剂粉末在内镜胆道结石切除后控制持续出血的疗效.
主要方法:
- 一名72岁的患有胆病和急性胆炎的妇女接受了ERCP与石头去除.
- 术后出血最初是用上腺素和内分泌剂来控制的,但持续了.
- 血静粉 (Hemospray®) 用于控制耐火性出血.
主要成果:
- 通过ERCP成功切除一个5.8mm的远端胆结石.
- 瘤切除术后的初始出血是轻微的,但后来进展为黑色素和显著的血红蛋白下降.
- 静血粉应用导致成功停止出血.
- 患者在没有复发出血或胆道阻塞的情况下出院.
结论:
- 尽管采用标准的内镜干预措施,但ERCP后的持续性出血可能会发生.
- 静血粉是一种有效的选择,用于管理ERCP后耐火性出血.
- 多模式内镜管理策略对于胆道干预患者的治疗结果至关重要.
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