在服用抗血栓剂的患者中,内镜手有潜力减少胃内镜膜下切割后的出血:多中心II期研究
Osamu Goto1,2, Yoshinori Morita3, Hiroshi Takayama3
1Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
概括
在服用抗血栓剂 (ATA) 的患者中,内镜手 (EHS) 有效地减少了胃内镜下粘膜解剖 (ESD) 后的术后出血. 这种技术为高危患者管理出血风险提供了有希望的解决方案.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 在瘤学瘤学.
背景情况:
- 手术后出血是胃内镜下粘膜切割 (ESD) 后的重大风险,特别是在服用抗血栓剂 (ATA) 的患者中.
- 在胃ESD后需要持续ATA治疗的患者中,管理出血并发症仍然是一个临床挑战.
研究的目的:
- 评估内镜手 (EHS) 在预防胃ESD后延迟术后出血的有效性.
- 评估EHS在接受胃ESD的高风险患者的安全性和技术成功.
主要方法:
- 一项多中心II期研究招募了接受胃ESD的患者,这些患者继续进行外科手术期间的ATA.
- 粘膜缺陷被使用EHS损伤后去除来关闭.
- 主要结局是经过3-4周评估的术后出血率;技术成功和不良事件也被监测.
主要成果:
- 这项研究招募了49名患者,其中43名患者在每协议组中.
- 手术后出血率为7.0%,可信区间上限低于预定义的值.
- 内镜手部 suturing 证明了100%的技术成功率和最小的不良事件.
结论:
- 内镜手部 suturing (EHS) 似乎是一个有效的方法,以预防术后出血的患者经历胃ESD,而在持续的抗血栓治疗.
- 在高风险患者中,EHS是一种安全且在技术上成功的程序,用于管理胃ESD缺陷.
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