内镜的临床影响在严重的血小板缺血患者血液恶性瘤经历胃肠道出血

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Badr Alhumayyd¹, Ashton Naumann², Amanda Cashen³

¹Department of Gastroenterology, King Saud University, Riyadh 22480, Ar-Riyāḍ, Saudi Arabia. balhumayyd@gmail.com.

World journal of gastrointestinal endoscopy

|February 24, 2025

概括

内镜干预对于患有血液性恶性瘤和严重血小板缺血,经历胃肠道出血 (GIB) 的患者来说是安全的. 紧急内镜没有改善死亡率,但在30天内减少了复发性出血.

科学领域:

胃肠病学胃肠病学
血液学血液学血液学
在瘤学瘤学.

背景情况:

胃肠道出血 (GIB) 是全球住院的重要原因之一.
患有血液性恶性瘤的患者面临由于血小板缩和血小板功能障碍而增加的GIB风险.
在这些患者内镜干预的最佳血小板水平仍未确定.

研究的目的:

评估内镜干预的安全性和结果,在住院患者血液恶性瘤和严重的血小板缺血呈现与急性明显的GIB.
为了比较内镜干预和保守管理之间的结果.
分析内镜时间对患者结果的影响.

主要方法:

单中心回顾性研究 (2018-2020年) 住院患者的血液恶性瘤,急性明显的GIB,血小板数 ≤50 × 10⁹/L.
评估结果:死亡率,输血需求,住院时间,ICU入院和复发性出血.
亚组分析比较紧急 (<24小时) 与延迟 (>24小时) 内镜.

主要成果:

包括76名患者;平均血小板计数为24.3 (内镜) 和14.6 (保守).
在30天或1年死亡率,复发性出血,输血需求或内镜和保守治疗之间的停留时间之间没有显著差异.
紧急内镜没有与死亡率的改善有关,但与30天复发出血的减少有关.

结论:

没有内镜的医疗辅助治疗是患有血液性恶性瘤和严重血小板缺血的患者急性非变节性GIB的可行的替代方案.
在这种高风险人群中,内镜干预似乎是安全的.
内镜检查的时间可能会影响复发出血率.

关键词:

内镜检查是指内镜检查.胃肠道出血胃肠道出血胃肠道出血死亡率血液的恶性瘤.血小板减少症 (Thrombocytopenia) 是一个严重的疾病.

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