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单独进行内镜带绑定,并与结肠分管出血的剪切相结合:回顾性比较研究

Noritaka Ozawa¹, Kenji Yamazaki¹, Nae Hasebe¹

¹Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan.

Endoscopy international open

|March 20, 2025

概括

将内镜带绑定 (EBL) 与剪切 (EBL-C) 结合起来,对治疗结肠分管出血 (CDB) 有希望. 这种新的方法可能会降低再出血率,与单独的EBL相比,部形成是成功的关键.

科学领域:

胃肠病学和内镜检查
消化系统疾病消化系统疾病
最少侵入性的手术

背景情况:

结肠分管出血 (CDB) 是一个重大的临床挑战.
目前的内镜血静止方法包括单独剪切或单独内镜带绑定 (EBL).
需要改进的静血技术来降低再出血率.

研究的目的:

评估一种新的结合内镜带绑定和剪切 (EBL-C) 方法对CBD的血液静止的有用性.
为了比较EBL-C与单独的EBL在预防结肠分泌体早期再出血方面的疗效.
为了确定EBL-C.治疗的患者早期再出血的风险因素.

主要方法:

从2019年3月到2024年7月,对138名CBD患者进行了内镜治疗的回顾性研究.
两个组的比较:EBL (n=24) 和联合EBL-C (n=56).
在EBL-C组中分析EBL-C组中早期 (30天内) 重出血的危险因素.

主要成果:

与EBL组 (25.0%) 相比,EBL-C组的早期再出血率较低 (8.9%),尽管在统计学上并不显著 (P=0.0776).
部形成的失败是再次出血的唯一独立风险因素 (aOR 0.076,P=0.0023).
在EBL-C组 (89.3%) 与EBL组 (66.7%) (P=0.0235) 中,成功的部形成显著更高,EBL-C是成功部形成的独立因素 (aOR 7.01,P=0.0095).

结论:

结合EBL-C方法可能比单独的EBL更有效,通过促进更好的绑定,防止从结肠分流器重新出血.
成功的部形成对于防止早期再出血至关重要.
难以管理的分流器仍然是内镜血液静止的一个挑战.

关键词:

诊断和成像 (包括染色内镜,NBI,iSCAN,FICE,CLE等等)内镜下部消化道下部消化道下部胃肠道出血胃肠道出血多胞胎 / 腺瘤 / ...

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