紧急对早期内镜对急性上胃肠道出血结果的影响:一项回顾性研究
Katarzyna Stasik1,2, Katarzyna Ferenc2, Krystian Partyka1,2
1Gastroenterology Clinic, Center for Comprehensive Treatment of Inflammatory, Bowel Disease Regional Hospital No. 2 in Rzeszow, Rzeszow, 35-301, Poland.
Canadian journal of gastroenterology & hepatology
|December 2, 2025
概括
与早期内镜 (6-24小时) 相比,紧急上部胃肠内镜 (<6小时) 并没有改善结果. 患者的严重程度,而不是时间,影响急性胃肠道出血的临床结果.
科学领域:
- 胃肠病学和肝病学
- 临床内镜检查 临床内镜检查
- 急性护理医学急性护理医学
背景情况:
- 急性上部胃肠道出血 (UGI) 是死亡的一个重要原因.
- 目前的指导方针建议在24小时内进行内镜检查,但非常早期 (<6小时) 与早期 (6-24小时) 内镜检查的益处仍在争论中.
研究的目的:
- 分析紧急 (<6小时) 与早期 (6-24小时) 上部胃肠内镜对急性UGI出血患者临床结果的影响.
主要方法:
- 对599名接受UGI内镜检查急性出血的患者进行了回顾性队列研究.
- 根据专家咨询时间,患者分为紧急 (<6小时) 和早期 (6-24小时) 内镜组.
- 倾向性得分匹配用于控制基线风险因素.
主要成果:
- 未经调整的分析显示,紧急内镜与更糟糕的结果相关,包括更长的住院时间和更高的复出出血率,可能是由于病情更严重的患者.
- 在倾向-得分匹配后,内镜时间不是结果的独立预测因素.
- 诸如Rockall的得分,GB的得分和活跃出血的存在等因素与预后不佳有关.
结论:
- 内镜的时间 (紧急与早期) 在调整患者严重程度后,不能独立预测急性UGI出血的临床结果.
- 临床结果的差异主要是由患者的整体症状严重程度和并发症负担驱动的,而不是内镜时间本身.
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