使用一种新型的静血溶液,在胃瘤的内镜下粘膜剖析后预防出血
Kuniyo Gomi1, Yorimasa Yamamoto2, Erika Yoshida2
1Department of Gastroenterology, Showa University Fujigaoka Hospital, Yokohama 227-8501, Kanagawa, Japan. kunxaqua@med.showa-u.ac.jp.
World journal of gastrointestinal endoscopy
|April 5, 2024
概括
在胃的内镜下粘膜解剖 (ESD) 后,PuraStat并没有防止出血. 重力可能会影响PuraStatStat
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 在瘤学瘤学.
背景情况:
- 内镜下粘膜切割 (ESD) 是早期胃癌的标准.
- 在4.4%的患者中出现ESD后,造成出血风险.
- 普拉斯塔特 (PuraStat) 是一种新型的静血溶液,被研究用于预防出血.
研究的目的:
- 评估PuraStat在预防ESD后胃的出血方面的疗效.
- 为了比较PuraStat治疗患者和对照组之间的出血率.
主要方法:
- 这是一项回顾性研究,将接受PuraStat治疗的101名患者 (P组) 与接受ESD治疗的297名对照患者 (C组) 进行比较.
- 在2022年5月至2023年3月 (P组) 和2017年4月至2021年3月 (C组) 期间收集的数据.
- 统计分析包括相对风险和多变量分析出血风险因素.
主要成果:
- 在ESD后的出血率相似:P组5.9%,C组6.7% (P>0.05).
- 两组之间出血风险没有显著差异 (相对风险:1.01).
- 切割直径≥50毫米和口服抗凝剂的使用是出血的重要危险因素.
结论:
- 普拉斯塔特的应用与ESD后出血减少无关.
- 引力可能会影响PuraStat的有效性,需要进一步调查.
- 需要进一步的研究来澄清PuraStat在管理ESD后出血中的作用.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
60
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
60
Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
428
The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
428
Anticoagulant Drugs: Low-Molecular-Weight Heparins
690
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
690
Peptic Ulcer Disease IV: Management
91
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
91
Peptic Ulcer Disease V: Surgical Management and Nursing Care
302
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
302
Drugs for Peptic Ulcer Disease: Sucralfate as Mucosal Protective Agents
479
In the intricate landscape of the gastric lumen, excessive acid secretion disrupts the natural defense mechanisms, weakening the mucus-bicarbonate barrier. This vulnerability allows pepsin to infiltrate epithelial cells, digesting mucosal proteins and triggering erosion, leading to ulcer formation.
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
In this scenario, mucosal protective agents like sucralfate play an essential role. Sucralfate, a complex of sulfated sucrose and aluminum hydroxide, demonstrates its usefulness in acidic conditions,...
479


