在没有警报特征的年轻患者中,内镜的效用有限
Andrea Run Einarsdottir1, Sigrun Helga Lund2, Einar S Bjornsson1,3
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
Scandinavian journal of gastroenterology
|November 30, 2025
概括
没有消化不良警报特征的年轻人很少有显著的胃镜检查结果. 这表明,在这个人口群体中,上部内镜可能不必用于初步诊断,从而减少不必要的手术.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 诊断内镜检查 诊断内镜检查
背景情况:
- 目前的指导方针表明,警报特征指导年轻成年人消化不良的上部内镜决定.
- 在没有警报特征的年轻成年人中,胃镜检查结果的临床意义尚不清楚.
研究的目的:
- 评估临床意义上的胃镜检查结果在患有消化不良但缺乏警报特征的年轻成年人 (18-50岁) 中的患病率.
- 评估在没有警报特征的年轻成年人上部内镜的诊断产量.
主要方法:
- 对748名年龄在18-50岁的患者进行了回顾性分析,他们接受了第一次胃镜检查 (2018-2022年).
- 数据收集包括症状,内镜检查结果,以及遵守美国胃肠内镜学会 (ASGE) 2015年关于适当指示的指南.
- 适当的指示包括出血,贫血,消化不良,吐,减肥,家族癌症史,或可疑的成像.
主要成果:
- 在748名患者中,515名 (69%) 患者有充分的适应性;233名 (31%) 患者没有.
- 在有充分迹象的患者中,食道炎 (20%),胃 (4.1%) 和十二指肠 (4.1%) 是最常见的.
- 在没有足够的迹象的患者中,临床上有意义的发现很少见:1.7%患有十二指肠 (与H. pylori相关),0.4%患有胃,没有发现癌症.
结论:
- 没有警报特征的年轻人表现出临床上显著的胃镜检查发现率较低.
- 在没有警报特征的年轻人中,上部内镜的诊断产量与具有警报特征的年轻人相比显著较低.
- 研究结果支持重新考虑上部内镜的常规使用,以初步评估缺乏警报特征的年轻成年人的消化不良.
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