普通外科

内镜下止血很少用于治疗便血

作者:佚名 来源:爱唯医学网 日期:2017-07-10
导读

          这项回顾性研究的作者以3151例住院期间行结肠镜检查的便血患者为研究对象,对接受内镜下止血的患者与未接受内镜下止血的患者进行了比较。

关键字:  内镜下止血 

        这项回顾性研究的作者以3151例住院期间行结肠镜检查的便血患者为研究对象,对接受内镜下止血的患者与未接受内镜下止血的患者进行了比较。研究发现,仅有144名患者(4.6%)接受了内镜下止血治疗,其中大多数是美国麻醉医师学会身体状况评分(ASA分级)为低风险的白种老年男性患者,以及在社区医疗单位接受结肠镜检查的患者。那些接受内镜下止血的患者更容易出现合并症,更需要内镜到达盲肠才能发现存在的动静脉畸形或孤立性溃疡。

        这些数据提示社区医疗单位和三级医疗中心对便血患者的治疗策略存在差异,特别是在社区医疗单位中内镜下止血治疗使用率较低。

TAKE-HOME MESSAGE

        The authors of this retrospective study characterized 3151 patients with hematochezia who underwent in-patient colonoscopy, comparing patients who received endoscopic hemostasis with those who did not. Only 144 patients (4.6%) underwent endoscopic hemostasis, most of whom were older white men with low-risk American Society of Anesthesiologists classification and who received colonoscopy in a community setting. Those receiving endoscopic hemostasis were more likely to have comorbidities, have the cecum reached, and be diagnosed with arteriovenous malformations or a solitary ulcer.

        These data identify differences between treatment strategies for patients with hematochezia in the community setting and the tertiary care setting, specifically the low rate of endoscopic hemostasis employed in the community setting.

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