非上腺素单一治疗与高风险PUB患者的组合治疗相匹配
Jingsong Wang1,2, Lintao Yu1, Linlin Liu1
1Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Scientific reports
|April 14, 2025
概括
对于有可见血管的胃出血 (PUB) 患者,将上腺素添加到非上腺素注射单一治疗中,可以显著减少再出血. 然而,对于喷发性或排泄性,单一疗法与联合疗法同样有效.
科学领域:
- 胃肠病学 胃肠病学
- 内镜血液静止症 (endoscopic hemostasis) 是一种内镜血液静止症.
- 胃肠道出血 胃肠道出血
背景情况:
- 目前的指导方针对使用上腺素与非上腺素注射单一疗法用于胃出血 (PUB) 中的静血缺乏明确性.
- 确定PUB的最佳内镜血静止策略对于患者的治疗结果至关重要.
研究的目的:
- 为了比较PUB患者的非上腺素注射单一治疗与组合治疗 (包括上腺素) 的静血疗效.
- 根据Forrest分类来评估复出率.
主要方法:
- 对接受内镜注射治疗的548名PUB患者的回顾性分析 (2014年3月至2023年1月).
- 患者被分为单疗法 (MT) 和组合疗法 (CT) 组.
- 倾向分数匹配 (PSM) 和根据Forrest分类进行分层分析被用于比较复出血率.
主要成果:
- 对于没有出血的可见血管 (Forrest FIIa),CT与MT相比,在3,7,14和30天显著降低了再出血率 (P < 0.001).
- 在MT和CT之间,对于刺激出血 (FIa),流血出血 (FIb) 或附着血块的血静效果没有发现显著差异.
- 组合疗法在Forrest FIIa中显示出更高的静血疗效.
结论:
- 非上腺素注射单一治疗是有效的PUB与喷射 (FIa) 或流 (FIb) 出血.
- 与上腺素的联合疗法优于PUB的单一疗法,使用非出血可见血管 (FIIa) 预防再出血.
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