在胃粉样化症中出现严重的活检后出血和穿孔的情况
Sho Matsuyama1,2, Akihisa Fukuda1, Go Yamakawa1,2
1Department of Gastroenterology and Hepatology Graduate School of Medicine, Kyoto University Kyoto Japan.
胃 Amyloidosis 在活检后增加出血和穿孔风险. 推使用剪贴血静,而不是凝血血静,以尽量减少这些脆弱患者的组织损伤.
科学领域:
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 胃粉症,特别是透析相关的粉症,存在诊断方面的挑战.
- 粉样化症患者表现出血管和组织脆弱性增加,从而增加了手术风险.
研究的目的:
- 在患有胃粉样化症的患者中报告严重的活检后出血和胃穿孔病例.
- 为了突出与amyloidosis患者内镜手术相关的风险.
- 在amyloidosis患者的胃肠道手术中推最佳的血液静止技术.
主要方法:
- 在透析的70岁男性患者中进行了带有活检的食管胃管腺镜检查.
- 使用凝血和剪切血液静止治疗严重的活检后出血.
- 胃穿孔的外科干预.
主要成果:
- 患者经历了严重的活检后出血,需要多次静血试验.
- 胃孔穿孔发生了尽管静血,需要手术.
- 病理学检查证实了与透析相关的二次性胃粉样化症.
结论:
- 胃 Amyloidosis 的患者在内镜活检后有高出血和穿孔的风险.
- 剪片止血是凝血止血的一个更安全的替代方案,由于最小化了组织创伤.
- 仔细考虑血液静止技术对于管理粉样化症患者的胃肠道手术至关重要.
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