内镜粘合剂注射与粘合剂加BRTO或TIPSS用于预防胃腹出血:一个随机对照试验
Sagnik Biswas1, Manas Vaishnav1, Shivanand Gamanagatti2
1Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.
概括
放射性干预 (RI) 与单独的内镜治疗相比,在肝硬化患者中显著降低了胃变节再出血和相关死亡率. 这种方法为急性水出血提供了改进的二次预防.
科学领域:
- 胃肠病学 胃肠病学
- 干预性放射学 干预性放射学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 肝硬化患者患有急性心底性水出血需要有效的二次预防.
- 用烯酸粘剂 (EIS-CYA) 进行内镜注射硬化疗法是主要治疗方法,但复出血率可能很高.
研究的目的:
- 为了比较单独使用EIS-CYA与与放射性干预 (RI) 结合使用EIS-CYA的疗效,用于胃静脉 (GV) 患者的二次预防.
- 评估一年内GV再出血率的主要结果.
主要方法:
- 一项随机对照试验,涉及90名肝硬化患者,患有来自心脏基础静脉的急性水出血.
- 患者最初接受了EIS-CYA. 第1臂 (内镜干预-EI) 接受了重复的EIS-CYA. 第2臂 (放射性干预 - RI) 接受了横性肝内移植系统分流或气球封闭的逆向透静脉消灭,随后进行了内镜监测.
主要成果:
- 与EI手臂 (24.4%) 相比,RI手臂在1年内显示出明显较低的GV再出血率 (2.2%).
- 与GV再出血相关的死亡率在EI手臂 (17.8%) 与RI手臂 (2.2%) 相比显著更高.
- 两组之间没有观察到任何原因死亡率的显著差异.
结论:
- 放射性干预 (RI) 是一种优越的策略,用于二次预防的胃静脉和有血流病史的患者.
- RI有效降低了GV再出血和相关死亡率,改善了肝硬化患者的治疗结果.
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