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血管凝固在第三空间内镜:一个随机控制试验

Antonio Capogreco¹, Roberta Maselli^2,3, Davide Massimi⁴

¹Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy.

|January 6, 2026

概括

用盐水浸泡进行预密封,可显著减少第三空间内镜手术期间的手术内出血. 这种新的技术通过尽量减少出血事件和需要额外干预来提高患者的安全性.

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
最少侵入性手术的方法

背景情况:

第三空间内镜对于瘤和运动障碍至关重要,但具有高出血风险.
减轻出血的传统方法涉及仪器交换,增加了复杂性.
一种新的方法是使用盐水浸泡来预先密封下血管.

研究的目的:

评估盐水浸泡预密封在第三空间内镜期间减少手术内出血的有效性.
为了比较盐水浸泡预密封与传统的凝结方法.
评估对出血率的影响,重新治疗的必要性和凝血时间.

主要方法:

一个随机对照试验,比较盐水浸泡预密封 (研究组) 与常规凝血 (对照组).
包括接受内镜下粘膜解剖 (ESD) 或口腔内镜肌切除术 (POEM) 的患者.
主要结局是每位患者的过程内出血率,需要重新治疗的血管≥1.2毫米.

主要成果:

盐水浸泡前密封显著降低了每位患者 (32.4%对75.8%) 和每只血管 (6.3%对29.9%) 的出血率.
在盐水浸泡组中,对辅助凝血装置的需求显著下降 (0%vs24.2%).
凝血时间也显著减少了盐水浸泡预密封 (22.7s vs 29.6s).

结论:

盐水浸泡预密封在第三空间内镜过程中大大降低了手术内出血风险.
该技术在每位患者和每位血管分析中都被证明是有效的.
这些发现支持在临床实践中实施盐水浸泡预密封.

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