结肠直径出血的最低结肠镜观察时间:基于5%平原时间的新基准
Chikamasa Ichita1,2, Tadahiro Goto3,4, Takashi Nishino1
1Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Kanagawa, Japan.
建议进行40分钟的结肠镜观察时间,以检测结肠管出血 (CDB) 中最近出血 (SRH) 的标记. 这一基准有助于优化胃肠道出血的检测率和程序效率.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 结肠分管出血 (CDB) 在日本和美国导致大量住院治疗.
- 在结肠镜检查期间识别最近出血 (SRH) 的印对于有针对性的血液静止和减少再出血至关重要.
- 目前的结肠镜观察时间缺乏标准化,导致操作员的变化和潜在的错过诊断或增加患者负担.
研究的目的:
- 为了建立最低结肠镜观察时间的实际基准.
- 确保在患有CDB的患者中可靠检测SRH.
主要方法:
- 对接受结肠镜检查的急性出血症患者的回顾性分析.
- 定义"5%平原时间"为新SRH检测持续下降到5%以下的间隔.
- 基于extravasation的发现进行了基于CT的分层分析.
主要成果:
- 总体5%的平原时间为40分钟.
- 在845名患者中,SRH在33.8%的患者中被检测到,中位检测时间为19分钟.
- 根据CT发现的平原时间有所不同:40分钟 (无外流),35分钟 (右侧) 和30分钟 (左侧).
结论:
- 40分钟的观察期作为最低结肠镜检查时间的实际基准.
- 这一基准有助于在不必要的程序延长的情况下可靠地检测SRH.
- 观察时间基准可以通过CT发现进行分层,以提高准确性.
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