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肝硬化患者急性水出血的内镜的时间:一个多中心队列研究

Javier Tejedor-Tejada¹, Benito Hermida², Cristina Camblor²

¹Department of Gastroenterology, University Hospital of Cabueñes, Gijón, Spain - jtejedor1991@gmail.com.

Minerva gastroenterology

|October 21, 2025

概括

对于患有急性水出血 (AVB) 的肝硬化患者,在12小时内进行紧急内镜检查并没有改善30天死亡率或治疗失败. 早期内镜 (12-24小时) 显示了类似的短期结果,但住院时间较短.

科学领域:

胃肠病学胃肠病学
肝病学肝病学是一种肝病学.
内镜手术进行内镜手术

背景情况:

对于患有急性水出血 (AVB) 的肝硬化患者进行内镜检查的最佳时间尚未确定.
这项研究研究了内镜计时对AVB患者短期结果的影响.

研究的目的:

为了确定12小时内进行内镜检查与12-24小时内进行内镜检查是否会影响AVB的肝硬化患者的短期结果.
在这个患者群体中确定30天死亡率的风险因素.

主要方法:

在2016-2022年间对183名AVB肝硬化患者进行内镜检查的回顾性评估.
患者被分为紧急 (<12小时) 和早期 (12-24小时) 内镜组.
主要结局:30天死亡率. 二次结局:治疗失败,ICU入院,住院时间 (LOS). 对风险因素的多变量分析.

主要成果:

紧急和早期内镜组之间30天死亡率 (6.7%对7.4%),治疗失败 (12.4%对10.6%) 或ICU入院 (3.4%对6.4%) 没有显著差异.
与早期组 (11.9天) 相比,紧急内镜组 (14.1天) 的住院时间明显长.
梅尔德-纳分数和格拉斯哥-布拉奇福德分数是30天死亡率的独立风险因素.

结论:

与早期内镜 (12-24小时) 相比,在12小时内紧急内镜对患有AVB的肝硬化患者没有改善短期结果.
早期内镜可能是一个可行的策略,可能减少住院时间.
在预测AVB患者的死亡风险方面,MELD-Na和格拉斯哥-布拉奇福德得分至关重要.

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