不同类固醇疗法在内镜下粘膜剖析后预防食道狭窄的有效性:一个比较的元分析
Shunhai Zhou1, Xuanran Chen2, Mingzhi Feng3
1The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
Gastrointestinal endoscopy
|August 22, 2024
概括
综合类固醇的使用在内镜下粘膜切割后预防食道狭窄是最有效的. 类固醇可以改善预后,但需要更多的研究来确认最佳的施用方法.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 内镜下粘膜切割 (ESD) 是表面食道癌 (SEC) 的标准.
- 手术后食道狭窄是ESD的一个常见并发症.
- 预防狭窄的最佳类固醇管理仍然不清楚.
研究的目的:
- 评估不同类固醇施用方法的有效性和安全性,以预防 SEC 患者在 ESD 后食道狭窄.
主要方法:
- 对25项涉及1555名患者的研究进行了元分析.
- 治疗组包括:没有预防 (CON),类固醇注射 (SI),口服类固醇 (OS) 和联合SI+OS.
- 评估的结果是术后食道狭窄率和需要进行内镜气球扩张 (EBD) 会议.
主要成果:
- 联合类固醇注射和口服类固醇 (SI+OS) 显示在预防收缩方面效果最高 (98.9%).
- 与没有预防相比,类固醇干预显著降低了收缩率和EBD会话.
- 不良反应<10%和一般轻微.
结论:
- 综合类固醇管理 (SI+OS) 似乎是预防ESD后食道收缩最有效的.
- 类固醇可以提高ESD后狭窄的预后.
- 需要高质量的随机对照试验来证实这些发现.
相关概念视频
Esophageal Strictures-II: Clinical Features and Management
57
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
57
Esophageal Strictures-I: Introduction
70
Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
70
Barrett Esophagus-II: Clinical Manifestations and Management
127
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
127
Gastroesophageal Reflux Disease II: Clinical Features and Management
62
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
62


