在患有严重食道炎的患者中,定制后续内镜检查
Rebecca K Grant1, William M Brindle1,2, Caitlyn L Taylor1
1The Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UK.
Frontline gastroenterology
|March 15, 2024
概括
在严重的食道炎中,随访食道胃肠透镜 (OGD2) 对非脆弱的患者最有益. 这种方法有助于量身定制调查,将资源集中在那些更有可能检测到像巴雷特食道这样的重大疾病的人身上.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 内镜检查是指内镜检查.
背景情况:
- 严重的食道炎 (洛杉矶等级C/D) 需要谨慎管理.
- 在这些患者中,随访食道胃管腺镜检查 (OGD2) 的有用性仍在争论中.
- 确定OGD2的适当候选者对于资源分配至关重要.
研究的目的:
- 评估OGD2在严重食道炎的临床效用.
- 通过OGD2.2评估巴雷特食道 (BO),癌症,发育不良和狭窄的诊断产量.
- 确定临床虚弱度量表 (CFS) 是否可以识别受益于OGD的患者2.
主要方法:
- 在2014-2015年间诊断出严重食道炎 (C/D级) 的患者的回顾性分析.
- 基于脆弱性 (CFS分数≥5) 和OGD2发现的患者分层.
- 单变量分析以确定与OGD2收益率相关的因素.
主要成果:
- 在13.2%的患者中,OGD2产生了新的病理,BO是最常见的 (10.1%).
- 虚弱的患者 (CFS ≥5) 的死亡率很高 (88.6%),OGD2的新诊断很少.
- 在非脆弱的患者中,OGD2在D级食道炎中更频繁地发现BO (p=0.010),但癌症,发育不良和狭窄率在各级都相似.
结论:
- 严重食道炎的OGD2应主要考虑非脆弱患者.
- 根据临床脆弱性量身定制OGD2可以优化诊断产量.
- 患有严重食道炎的非脆弱患者表现出相似的重大病理率,无论C级或D级.
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