对于腐蚀性损伤的新兴内镜评估的作用:我们应该这样做还是不应该?
Ji Hyun Kim1, Ji Min Kim2, Bumhee Park2
1Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
对于腐蚀性摄入的紧急内镜通常是不必要的,因为大多数患者显示轻微的伤害. 出血和白细胞瘤是严重损伤 (扎尔加尔等级≥2b) 的关键指标.
科学领域:
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
- 毒理学 毒理学 毒理学
背景情况:
- 腐蚀性摄入需要立即进行医疗评估.
- 早期内镜评估对预测腐蚀性摄入的结果的有用性仍在争论中.
- 识别那些从紧急内镜中获益最多的患者至关重要.
研究的目的:
- 在患有腐蚀性摄入的患者中确定预测严重内镜发现 (扎尔加等级≥2b) 的因素.
- 为指导在入院时需要紧急内镜评估的患者的选择.
主要方法:
- 对211名食用腐蚀性物质的患者 (2010-2023) 的回顾性审查.
- 对短期和长期内镜结果的分析.
- 后勤回归用于识别Zargar等级≥2b的风险因素.
主要成果:
- 大多数患者 (47.9%) 没有初始的粘膜损伤;狭窄和死亡是罕见的 (2.4%和1.4%).
- 出血事件 (OR=12.2) 和白细胞症 (OR=2.9) 是扎加尔等级≥2b的显著预测因素.
- 摄入量与严重的粘膜损伤无关.
结论:
- 对于所有腐蚀性摄入病例,可能不需要紧急内镜.
- 出血和白细胞瘤是严重腐蚀性损伤的关键指标.
- 早期内镜评估应以特定的临床因素为指导,而不仅仅是摄入物质.
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