对非静脉上胃肠道出血进行内镜的时间:一项观察性研究
Seong Woo Jeon1, Joong Goo Kwon2, Ju Yup Lee3
1Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
概括
紧急内镜检查并不总是对于非的上部胃肠道出血 (NVUGIB) 需要的. 延迟内镜对于低风险患者来说是足够的,而紧急内镜则通过减少并发症恶化,有利于高风险患者.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 临床结果 临床结果
背景情况:
- 非静脉上部胃肠道出血 (NVUGIB) 的管理通常涉及早期内镜干预.
- 关于NVUGIB紧急内镜疗法的疗效的数据有限.
- 格拉斯哥 - 布拉奇福德得分有助于评估出血的严重程度.
研究的目的:
- 为了评估不同时间到内镜间隔的有效性,用于非静脉上部胃肠道出血 (NVUGIB).
- 根据内镜干预的时间来评估出血结果,包括再出血,死亡率和发病率.
- 确定格拉斯哥-布拉奇福德得分是否可以预测与内镜定时相关的结果.
主要方法:
- 对从1554名NVUGIB患者前性收集的多中心数据的回顾性审查.
- 患者被分为早期 (<24小时) 与延迟 (≥24小时) 和紧急 (<6小时) 与非紧急 (≥6小时) 的内镜组.
- 对再出血,死亡率,二次干预,输血和发病率恶化的分析.
主要成果:
- 延迟内镜与较低的再出血率有关 (HR:0.576),特别是在低风险患者中 (HR:0.417).
- 与低风险患者相比,接受非紧急内镜检查的高风险患者在医院内增加了并发症恶化 (HR: 2.957).
- 延迟内镜组的输血率更高.
结论:
- 延迟内镜足以在低风险患者中管理非变形上胃肠道出血.
- 高风险患者的紧急内镜可以减少住院期间的并发症恶化.
- 内镜的时间应按风险分层进行,以实现最佳的NVUGIB管理.
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