在老年患者中,表现为急性非变节上部胃肠道出血的老年患者,内镜的最佳时间
Yavuz Cagir1, Muhammed Bahaddin Durak2, Ilhami Yuksel3,4
1Department of Gastroenterology, Ankara Bilkent City Hospital, Ankara, 06800, Turkey. yvzcgr@hotmail.com.
对于患有非的上部胃肠道出血 (NVUGIB) 的老年患者,内镜的最佳时机至关重要. 与晚期内镜相比,非常早期的内镜 (12小时内) 显著减少了手术干预的需要,并降低了30天死亡率.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 医学研究 医学研究
背景情况:
- 非 Variceal 上部胃肠道出血 (NVUGIB) 具有显著的风险,特别是在老年患者.
- 确定内镜干预的最佳时间对于改善这一群体的临床结果至关重要.
研究的目的:
- 评估内镜时间对NVUGIB治疗的老年患者 (≥65岁) 临床结果的影响.
- 为了确定最有益的内镜时间框架来管理老年人急性上部胃肠道出血.
主要方法:
- 一项回顾性研究比较了三个内镜定时组:非常早期 (<12小时),早期 (12-24小时) 和晚期 (>24小时).
- 评估的临床结果包括30天死亡率,内镜/手术干预的需要,再出血和住院时间.
- 血动力学不稳定或严重出血的患者在前12小时内接受了干预.
主要成果:
- 与晚期内镜相比,非常早期的内镜 (12小时内) 与需要手术/放射性干预的可能性显著降低.
- 三十天死亡率在各组之间有显著差异:15.6% (非常早),7.5% (早期) 和29.6% (晚).
- 晚期内镜 (24-48小时) 被确定为住院期间重新出血的独立预测因素 (OR: 3.133).
结论:
- 早期内镜检查,特别是在12小时内,似乎对治疗老年人急性NVUGIB有益.
- 这些发现表明,迅速的内镜干预可以减少侵入性手术的必要性,并改善上部胃肠道出血的老年患者的存活率.
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