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在晚期肝病的内镜变水栓结合后,肝脏和脏硬的急性变化-试点研究
Esra Görgülü1, Eva Herrmann2, Jonel Trebicka3
1Medical Clinic 1, University Hospital Frankfurt, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
透视性水绑定 (EVL) 可能导致肝脏和硬度的短期增加,反映出血液动力学变化. 过渡性弹性图 (TE) 显示出在肝病患者中EVL后监测这些变化的潜力.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 医疗成像医学成像
背景情况:
- 透视静脉绑定 (EVL) 是预防晚期慢性肝病 (ACLD) 静脉出血的标准.
- 评估EVL的急性血液动力学影响往往需要侵入性方法.
- 有限的数据存在于短期脏硬 (SS) 动态后EVL.
研究的目的:
- 使用过渡性弹性学 (TE) 来量化EVL后肝硬度 (LS) 和SS的短间隔变化.
- 探索硬度变化与临床/实验室参数之间的关联.
- 评估使用TE在EVL后的周围手术血液动力学监测的可行性.
主要方法:
- 对患有晚期肝病的成年人进行前性观察试点研究,接受了带有或没有EVL的EGD.
- 肝脏和脏TE在EVL发生前和12小时内进行.
- 用于分析患者内部变化和相关性的非参数方法.
主要成果:
- 在EVL小组 (n=21) 中,中位数LS在12小时内从27.6增加到45.1kPa,中位数SS从59.9增加到98.3kPa.
- 在LS和SS的增加显示了一个统一的方向,但没有达到统计学意义.
- 较高的基线SS预测了较大的LS增加;度与肌素,疾病持续时间,Child-Pugh类,白蛋白和结相关.
结论:
- 在EVL后的LS和SS的短期增加表明急性血液动力学变化,如增加肝输液和脏拥堵.
- TE,特别是SS测量,显示了在EVL后早期的术前血液动力学监测的可行性.
- 有序时间点和门压力验证的更大规模研究是有必要的.
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