急性出血性直肠的重出血风险:一个多中心回顾性研究
Takahiro Muramatsu1, Masakatsu Fukuzawa1, Akira Madarame1
1Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Japan.
Internal medicine (Tokyo, Japan)
|February 12, 2024
概括
在急性出血性直肠 (AHRU) 中再出血的危险因素包括表现不佳的状态,输血,低功能和特定的内镜发现. 识别这些因素有助于管理AHRU患者并预防复发.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 内部医学 内部医学
背景情况:
- 急性出血性直肠 (AHRU) 呈现出突然,大量的直肠出血.
- 有限的研究存在于AHRU再出血的风险因素.
- 有效的管理需要了解复发出血的预测因素.
研究的目的:
- 在患有AHRU的患者中,确定初始静血后再次出血的危险因素.
- 分析与AHRU复发相关的临床,内镜和治疗相关因素.
- 为临床实践提供信息,并改善AHRU患者的治疗结果.
主要方法:
- 149名AHRU患者的回顾性多中心研究 (2015年1月 - 2020年5月).
- 收集的数据包括患者人口统计学,并发症,药物,实验室结果,内镜检查结果,静血方法和临床过程.
- 使用多变量分析来确定重出血的重大风险因素.
主要成果:
- 在23% (35/149) 的患者中,复出血发生.
- 重新出血的重要预测因素包括表现不佳的状态 (PS 4),输血史,低估计的淋巴细胞过率 (eGFR),内镜检查期间对整个直肠的可视化不佳,以及使用单极静血.
结论:
- 低绩效状态 (PS4) 是AHRU再出血的关键风险因素.
- 血液输血史,低EGFR和不充分的内镜可视化与再出血风险的增加有关.
- 选择止血方法,特别是单极子,也可能影响复出出血率.
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