一种有针对性的内镜带绑定技术,用于治疗急性食道水出血
Gilberto Herrera-Quiñones1, Raúl Alberto Jiménez-Castillo2, Susana Isabel Scharrer2
1Gastroenterology Department, Facultad de Medicina y Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico; GI & Liver Transplant Unit, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi-Sunyer (IDIBAPS), Barcelona, Spain; Ciber de Enfermedades Hepáticas y Digestivas (CIBEREHD), Spain.
针对性内镜带绑定 (EBL) 用于食道静脉与最近出血的伤痕减少了手术内出血事件. 这种方法有望改善急性水出血的管理.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 内镜带绑定 (EBL) 是食道静脉 (EV) 的标准.
- 传统的EBL从远端进入近端食道.
- 针对最近出血的伤痕 (白色乳头标志) 可能会改善结果.
研究的目的:
- 将传统的EBL与针对EV的有针对性的方法进行比较.
- 评估近期水出血 (AVB) 污名的患者的疗效.
主要方法:
- 对92名近期出现EV出血的患者的病例控制研究 (2016年12月至2019年9月).
- 目标组:第一个带放置在出血的伤痕上,其次是标准的EBL.
- 传统组:标准EBL从远端食道向上.
主要成果:
- 针对性EBL在内镜检查期间发生的活跃出血事件较少 (6.5%对20.0%,p=0.021).
- 在目标群体中,带脱落的发病率较低 (p=0.418).
- 死亡率,再出血或输血需求没有显著差异.
结论:
- 针对EV的有针对性的EBL与最近出血的伤痕与较少的手术内出血事件有关.
- 目标技术表明带脱离的发生率很低.
- 研究的局限性需要谨慎地解释研究结果.
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