老年胆道排水中的支架选择:从良性到恶性的实用指南
1Department of Internal Medicine, Suez University, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg.
World journal of gastrointestinal endoscopy
|January 29, 2026
概括
对于老年人 (70岁以上),塑料支架 (PS) 和金属支架 (MS) 对胆道排水具有相似的通透性. 在恶性病例中,MS显著延迟了复发,而在良性病例中,PS提供了更容易的重新干预.
科学领域:
- 干预性内镜检查是干预性的内镜检查.
- 胃肠病学 胃肠病学
- 老年医学 老年医学
背景情况:
- 全球人口老龄化在干预内镜方面面临越来越多的挑战.
- 一个常见的临床困境涉及选择塑料支架 (PS) 和金属支架 (MS) 之间的老年患者 (≥70岁) 的内镜超声波引导胆道排水.
研究的目的:
- 分析PS与MS在70岁及以上患者胆道排水方面的有效性.
- 根据疾病病因 (良性与恶性) 和患者因素为支架选择提供决策框架.
主要方法:
- 追溯分析70岁及以上的患者进行内镜超声波导导导胆管排水.
- 在PS和MS组之间比较支架通透度和时间到复发性胆道阻塞.
主要成果:
- 塑料支架 (PS) 和金属支架 (MS) 在混合患者队列中表现出可比的透度.
- 在恶性病例中,金属支架 (MS) 显著延长了复发性胆道阻塞的时间,特别是当未进行前级支架时.
结论:
- 对于脆弱老年患者的良性胆道疾病,简单的PS重新干预是有利的.
- 对于这个年龄组的恶性胆道阻塞,MS是有利于最大限度地提高支架通透性和最大限度地降低程序负担.
- 这些发现支持个性化,特定于年龄的胆汁排水策略,需要进行前性试验.
相关概念视频
Cavity Drainage and Flashings in Masonry walls
455
Typically, a cavity wall consists of two wythes separated by a gap of at least 2 inches, which may contain insulation while still maintaining a minimum clear space of 1 inch to facilitate adequate drainage. Advanced methods like the insertion of a continuous drainage mat can further reduce this space while ensuring effective moisture expulsion.
Weep holes, strategically placed at the base of the cavity, are critical for draining accumulated water. These openings are created by leaving head...
Weep holes, strategically placed at the base of the cavity, are critical for draining accumulated water. These openings are created by leaving head...
455
What is Natural Selection?
128.8K
Natural selection is an evolutionary process in which individuals with survival-promoting traits reproduce at higher rates. These favorable traits become more common within a population or species. Naturally selected traits initially arise via random genetic mutations. In order for selection to occur, there must be variation within a population, the trait controlling the variation must be heritable, and there must be an evolutionary advantage for variation in the trait.
128.8K
Antibiotic Selection
59.9K
Overview
59.9K
Types of Selection
44.8K
Natural selection influences the frequencies of particular alleles and phenotypes within populations in several different ways. Primarily, natural selection can be directional, stabilizing, or disruptive. Directional selection favors one extreme trait and shifts the population towards that phenotype while selecting against individuals displaying alternate traits. Stabilizing selection favors an intermediate trait with a narrow range of variation. Deviation from the optimal phenotype towards an...
44.8K
Frequency-dependent Selection
23.9K
When the fitness of a trait is influenced by how common it is (i.e., its frequency) relative to different traits within a population, this is referred to as frequency-dependent selection. Frequency-dependent selection may occur between species or within a single species. This type of selection can either be positive—with more common phenotypes having higher fitness—or negative, with rarer phenotypes conferring increased fitness.
23.9K
Limits to Natural Selection
34.8K
Organisms that are well-adapted to their environment are more likely to survive and reproduce. However, natural selection does not lead to perfectly adapted organisms. Several factors constrain natural selection.
34.8K


