在肝硬化时胃静脉瘤的侵略性与保守性内疗:一个随机对照试验
Ritesh Prajapati1, Subhash K Nandwani1, Rajiv M Mehta1
1Department of Gastroenterology, Surat Institute of Digestive Sciences, Surat, India.
Endoscopy
|June 17, 2025
概括
与保守治疗相比,在肝硬化中治疗胃静脉的侵略性烯酸盐治疗显示出类似的复出血和死亡率. 这一发现表明,保守的治疗可能是第一次胃水出血的可行选择.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内镜治疗疗法 内镜治疗
背景情况:
- 肝硬化中胃水出血是一个重要的临床挑战.
- 目前对胃变节的管理策略各不相同.
- 烯酸盐注射是一种常见的内镜治疗方法.
研究的目的:
- 为了比较激进与保守的烯酸治疗对胃静脉的疗效,在肝硬化患者呈现与他们的第一个静脉动脉出血.
- 评估再出血率,死亡率和治疗效率.
主要方法:
- 一项随机对照试验,涉及145名肝硬化和胃静脉瘤 (GOV1,GOV2,IGV1) 患者,他们首次经历了静脉瘤出血.
- 组A接受了积极的治疗 (消灭所有可见的静脉动脉).
- B组接受了保守治疗 (仅治疗带有出血标记或高风险特征的静脉动脉).
主要成果:
- 在1年复出率 (18.2%与15.0%) 或所有原因死亡率 (22.2%与32.9%) 中,侵略性和保守性组之间没有显著差异.
- 积极治疗导致更短的消灭时间和更少的内镜会议GOV1静脉.
- 在两组中,不良事件的发生率相似.
结论:
- 对胃变节的侵略性烯酸盐内疗产生了与保守治疗相似的复出血和死亡结果.
- 保守的管理是一种潜在的有效策略,用于第一次胃水出血.
- 进一步的研究可能会探索长期结果和成本效益.
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