作为第一线治疗胃潰瘍出血的超范围剪辑:多中心随机对照试验 (TOP研究)
Paola Soriani1, Paolo Biancheri1, Giuliano Francesco Bonura1
1Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy.
超视镜 (OTS) 片段在胃出血的初始血液静止中表现出比超视镜 (TTS) 片段更高的疗效,同样低的复出血率. 在治疗急性胃肠道出血方面,OTS剪辑提供了更好的临床成功.
科学领域:
- 胃肠病学 胃肠病学
- 进行内镜干预.
- 胃肠道出血管理 胃肠道出血管理
背景情况:
- 急性非静脉上部胃肠道出血 (NVUGIB) 的管理通常涉及内镜治疗.
- 在NVUGIB中,超视镜 (OTS) 剪辑显示出前景,但在胃潰瘍出血中与透视镜 (TTS) 剪辑的直接比较有限.
研究的目的:
- 为了比较OTS剪辑与TTS剪辑的疗效,作为急性胃潰瘍出血的第一线内镜治疗.
主要方法:
- 进行了一项国际性的多中心随机对照试验.
- 患有Forrest Ia-IIb胃的患者被随机分配到接受OTS剪贴或TTS剪贴治疗.
- 主要结局是30天的再出血;次要结局包括初始血液静止和整体临床成功.
主要成果:
- 与透视镜剪片相比,超视镜剪片的成功初始血液静止率 (98.4%vs. 78.4%) 和整体临床成功率 (96.7%vs. 74.5%) 显着更高 (P=0.001).
- 这两种方法都显示了30天的低复出率 (OTS为1.6%,TTS为3.9%,P=0.46).
结论:
- 使用OTS或TTS剪辑进行一线内镜治疗,导致急性胃潰瘍出血的复出血率较低.
- 在这种情况下,超视镜剪贴比透视镜剪贴更有效地实现成功的初始血液静止和整体临床成功.
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