经过口腔内镜肌肉切除后延迟下道出血的保守管理:一个病例报告
Martina Marrelli1, Dario Biasutto1, Benedetto Neri1,2
1Therapeutic GI Endoscopy Unit, Fondazione Policlinico Universitario Campus Bio-Medico, University of Rome, Rome, Italy.
Acta medica Lituanica
|March 10, 2025
概括
在口腔内镜肌切除术 (POEM) 治疗阿喀拉西亚可能会导致延迟出血. 保守的管理,包括停止LMWH,成功地治疗了一名POEM后的粘膜下血液瘤患者.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
背景情况:
- 透口内镜肌切除术 (POEM) 是治疗阿喀拉西亚的主要治疗方法.
- 粘膜下出血或血液瘤是POEM的罕见并发症,发生在约1%的病例中.
研究的目的:
- 在POEM后报告延迟出血和下血液瘤的病例.
- 为了评估这种并发症的保守管理的有效性.
主要方法:
- 一个患有II型阿喀拉西亚的患者接受了POEM.
- 在开始服用低分子量肝素 (LMWH) 后出现的延迟出血和下血液瘤.
- 保守的治疗包括禁食,抗生素,停止LMWH和密切监测.
主要成果:
- 患者表现为胸部疼痛,但没有活动性动脉出血.
- 避免了紧急内镜检查.
- 血液瘤在10天内完全消失.
结论:
- 保守的管理是安全和有效的延迟的下血液瘤POEM后.
- 这种方法可以避免在某些特定情况下需要紧急的内镜干预.
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