在内镜注射前添加片可以减少胃的宫外栓塞:一项随机对照试验
Guangchuan Wang1,2,3, Lijun Peng4,5, Ping Li6
1Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
The American journal of gastroenterology
|July 2, 2025
概括
预先剪切可显著降低腹腔外栓塞风险从内镜注射烯酸 (ECI) 胃变节. 这种增加了胃静脉的ECI的安全性,不会影响治疗的有效性或患者的存活率.
科学领域:
- 胃肠病学 胃肠病学
- 干预性内镜检查是干预性的内镜检查.
- 血管外科 血管外科
背景情况:
- 宫外栓塞是内镜手术期间的烯酸盐迁移的严重并发症.
- 胃静脉与胃突变带有这种栓塞事件的风险.
- 内镜注射蓝酸盐 (ECI) 是一种治疗选择,但血栓塞的风险需要缓解.
研究的目的:
- 为了评估先前剪切在减少ECI后宫外血栓塞的有效性,用于胃变节.
- 为了测试这种假设,剪贴辅助的ECI比传统的ECI更安全.
- 为了比较剪贴辅助与传统ECI的安全性和有效性.
主要方法:
- 一个多中心,随机对照试验,比较剪贴辅助ECI (Clip-ECI) 与传统ECI (Con-ECI).
- 35名患者被随机分配到每个组 (Clip-ECI与Con-ECI).
- 在注射后使用计算机断层扫描 (CT) 检测蓝酸迁移和栓塞.
主要成果:
- 与Con-ECI (42.9%) 相比,Clip-ECI显示了烯酸盐栓塞的发生率显著降低 (11.4%).
- 在Clip-ECI组中没有出现症状性栓塞,而Con-ECI组中的4名患者出现了症状性肺栓塞 (1例死亡).
- 技术成功,再出血率和生存率在各组之间是可比的,没有报告与片相关的出血.
结论:
- 在手术前剪切有效地降低了外阴栓塞的风险,在接受ECI的病人胃静脉与门系统的分流.
- 剪贴辅助的ECI提供了更好的安全性,而不会影响治疗疗效或生存结果.
- 这种技术代表了在减少栓塞并发症的胃变节管理中的宝贵进步.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
149
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
149
Esophageal Varices-I: Introduction
355
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
355
Endoscopic Procedures V: ERCP
965
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
965
Endoscopic Procedures III: Video Capsule Endoscopy
335
Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
335


