结肠分管出血的内镜疗法:一个系统的审查和元分析
Gilmara Coelho Meine1, Paula Santo2, Lucas Monteiro Delgado3
1Feevale University, Novo Hamburgo, RS, Brazil. gilmara@feevale.br.
Surgical endoscopy
|December 30, 2025
概括
结肠分管出血 (CDB) 的内镜治疗显示出高的成功率. 透视镜 (TTS) 剪贴的结果更糟糕,而内镜可拆卸的绳索绑定 (EDSL) 则有更多不良事件.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 临床研究 临床研究
背景情况:
- 结肠分管出血 (CDB) 是急性下胃肠道出血的常见原因之一.
- 有各种各样的内镜治疗方法,包括透视镜 (TTS) 剪贴,内镜带绑定 (EBL),内镜可拆卸的绳索绑定 (EDSL) 和超视镜剪贴 (OTSC).
研究的目的:
- 系统地审查和元分析CBD不同内镜治疗选择的有效性和安全性.
主要方法:
- 在PubMed,Embase和Cochrane图书馆的数据库中进行了搜索.
- 进行了一项比例元分析,以计算95%置信区间 (CI) 的汇总估计.
- 根据内镜治疗方式进行了子组分析,P<0.10被认为对子组差异具有重要意义.
主要成果:
- 包括21项观察性研究,共有3,161名参与者.
- 聚合成功的静血率为98.90% (95% CI 97.66-99.75%) 没有显著的亚组差异.
- 在TTS片段中,再出血和手术时间的结果较差;EDSL的不良事件率最高 (2.15%).
结论:
- 对于CDB的内镜治疗在所有方式中都提供了高的即时血静率.
- TTS剪辑与较差的结果有关,但没有一种方式在住院或死亡率上有显著差异.
- EDSL与更高的不良事件频率有关.
相关概念视频
Esophageal Varices-II: Clinical Features and Management
334
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
334
Inflammatory Bowel Disease V: Surgical Management
420
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
420
Endoscopic Procedures II: Colonoscopy
541
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
541
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
604
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
604
Esophageal Varices-I: Introduction
1.1K
Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
1.1K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
496
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
496


