高风险的耻辱和急性下胃肠道出血的治疗策略:在日本进行的一项全国性研究
Tomonori Aoki1, Eiji Sadashima2, Katsumasa Kobayashi3
1Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Endoscopy
|February 14, 2024
概括
对急性下部胃肠道出血 (ALGIB) 的内镜治疗可以减少再出血,特别是对右结肠分管出血. 治疗的有效性因出血的位置和原因而异,指导最佳的内镜策略.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 管理出血 管理出血
背景情况:
- 对于急性下部胃肠道出血 (ALGIB) 的内镜治疗的复出风险和结果尚未完全理解.
- 基于近期出血的血的出血位置,类型和病因学的变化存在.
研究的目的:
- 在ALGIB中确定高风险的内镜SRH.
- 为ALGIB提出一个最佳的内镜治疗策略.
主要方法:
- 从CODE BLUE-J研究中对2699名ALGIB患者的SRH进行了回顾性分析.
- 88.6%的患者接受了内镜治疗.
主要成果:
- 根据位置 (右结肠:28.6%与左结肠:15.5%) 和病因 (椎:27.5%与其他:8.9%),30天的复出出血率有显著差异.
- 内镜治疗减少了整体复出出血 (AOR 0.69),并且对右结肠SRH (AOR 0.46) 和分泌器出血 (AOR 0.60) 有意义.
- 绑定比剪切对右结肠分流管出血更有效.
结论:
- 一个人口级别的内镜数据集确定了高风险的SRH,并为ALGIB治疗策略提供了信息.
- ALGIB复出出血的风险取决于结肠位置,出血病因和治疗方式,而不是上部肠道出血.
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