识别患有肝硬化和急性胃肠道出血的低风险患者,这些患者可能不需要紧急内镜检查
Sijia Zhang1, Mingyu Sun2, Shanshan Yuan3
1Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (Teaching Hospital of China Medical University), No. 83 Wenhua Road, Shenyang, 110840, Liaoning, China.
Advances in therapy
|November 22, 2025
概括
对于低风险的肝硬化患者,急性胃肠道出血可能不需要紧急内镜检查. 这些患有儿童-皮格评分≤7且没有肝细胞癌的患者,无论他们是否接受了内镜检查,结果都相似.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 肝硬化患者急性胃肠道出血 (AGIB) 的紧急内镜是资源密集型,并带有风险.
- 识别那些可能不需要这种侵入性手术的低风险患者至关重要.
研究的目的:
- 为了识别患有肝硬化和AGIB的患者,他们可以安全地放弃住院内镜.
- 为了评估内镜在患有黑色素的低风险肝硬化患者的必要性.
主要方法:
- 追溯分析673名肝硬化患者和单独呈现黑色素的AGIB患者.
- 基于内镜的使用和查尔德-普格评分和肝细胞癌 (HCC) 与住院死亡的相关性评估的分类.
主要成果:
- 30.0%的患者 (202/673) 没有接受内镜检查.
- 在304名低风险患者中 (柴尔德 - 普格评分≤7,没有HCC),无论内镜检查如何,住院死亡率为0.0%.
- 在这种低风险人群中,内镜和非内镜组之间的5天出血控制失败率没有显著差异.
结论:
- 低风险的患有肝硬化,AGIB,黑色素,儿童皮格评分≤7,没有HCC的患者可能不需要紧急内镜检查.
- 这一发现可能有助于优化资源配置,并减少管理这些患者的程序风险.
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