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在早期结肠镜检查前紧急对比增强型计算机断层扫描用于治疗结肠垂出血:多中心随机对照试验
Yuichiro Hirai1, Toshio Uraoka2,3, Michiko Wada2
1Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan, yuichiro.hri.523@gmail.com.
在早期结肠镜检查之前的紧急对比增强计算机断层扫描 (CE-CT) 并没有改善结肠管出血 (CDB) 中最近出血 (SRH) 标记的识别. 由于缺乏临床益处,不建议在稳定的CDB患者中进行常规CE-CT.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
- 临床试验 临床试验
背景情况:
- 增强对比度的计算机断层扫描 (CE-CT) 越来越多地用于结肠分管出血 (CDB).
- 除了诊断之外,它在改善临床结果方面的作用仍然不清楚.
- 本研究调查了紧急CE-CT对CDB管理的影响.
研究的目的:
- 为了确定是否紧急的CE-CT在早期结肠镜检查 (≤24小时) 中改善了最近出血的标记 (SRH) 识别.
- 评估紧急CE-CT对CDB患者其他临床结果的影响.
主要方法:
- 一个随机的,开放的,受控的试验,涉及23个日本机构.
- 240名血液动力稳定患者被随机分配,他们怀疑有CDB.
- 组:紧急的CE-CT,然后是早期结肠镜检查与早期结肠镜检查.
主要成果:
- 两组之间SRH识别没有显著差异 (20.0%对17.8%,p=0.739).
- 成功的内镜血静率相似 (18.3%与17.8%,p=1,000).
- 没有观察到重新出血,住院或输血需求的显著差异.
结论:
- 在早期结肠镜检查之前紧急的CE-CT不会提高SRH检测或稳定的CDB患者的临床结果.
- 对于这个患者群体,不建议常规使用紧急CE-CT.
- 在CE-CT上对比度扩散的低率支持了这一结论.
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