Gastroenterology:内镜检查时机与急性下消化道出血患者预后

2019-09-29 MedSci MedSci原创

研究认为,急性下消化道出血患者在入院内24小时接受结肠镜检查不会改善患者新近出血病灶检出率或出血复发风险

近日,研究人员开展大型、多中心的随机对照试验,以确定早期结肠镜检查对急性下消化道出血(ALGIB)患者的疗效和安全性。

研究在日本15个医疗中心开展,170名ALGIB患者随机接受早期结肠镜检查(入院24小时内)或择期结肠镜(入院后24-96个小时)。研究的主要结果为新近出血病灶 (SRH)的鉴别。次要终点包括,30天内再出血,内镜治疗成功,需要输血,住院时间,30天内血栓事件,30天内死亡以及不良事件。

早期内镜组79人中17人鉴别出SRH(21.5%),择期组80人中17人鉴别出SRH(21.3%),差异不显著。早期内镜组30天内出血复发再住院率为15.3%,择期组为6.7%,组间内镜治疗成功率、输血率、住院时间、血栓事件或30天内死亡率差异不显著。早期组无失血性休克发生,而择期结肠镜组为2例(2.5%)。

研究认为,急性下消化道出血患者在入院内24小时接受结肠镜检查不会改善患者新近出血病灶检出率或出血复发风险。

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    2021-09-17 ms2000000182667314

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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Feb 07 14:04:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262131, encodeId=b8f81262131a3, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446544, encodeId=0fef14465440c, content=<a href='/topic/show?id=4a672015341' target=_blank style='color:#2F92EE;'>#下消化道出血#</a>, beContent=null, 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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1052193, encodeId=edf51052193e0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Fri Sep 17 06:21:39 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712109, encodeId=978b1e1210924, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Jun 24 04:04:00 CST 2020, time=2020-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064841, encodeId=87a82064841f3, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Tue Aug 18 10:04:00 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692077, encodeId=45bf16920e7c2, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Mon Oct 14 04:04:00 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1706047, encodeId=64441e0604779, content=<a href='/topic/show?id=6fb0521e42a' target=_blank style='color:#2F92EE;'>#急性下消化道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52174, encryptionId=6fb0521e42a, topicName=急性下消化道出血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14f431139253, createdName=zengjiayao, createdTime=Fri Nov 08 03:04:00 CST 2019, time=2019-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072712, encodeId=563620e27124f, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Feb 07 14:04:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262131, encodeId=b8f81262131a3, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446544, encodeId=0fef14465440c, content=<a href='/topic/show?id=4a672015341' target=_blank style='color:#2F92EE;'>#下消化道出血#</a>, beContent=null, 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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1052193, encodeId=edf51052193e0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Fri Sep 17 06:21:39 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712109, encodeId=978b1e1210924, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Jun 24 04:04:00 CST 2020, time=2020-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064841, encodeId=87a82064841f3, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Tue Aug 18 10:04:00 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692077, encodeId=45bf16920e7c2, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Mon Oct 14 04:04:00 CST 2019, time=2019-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1706047, encodeId=64441e0604779, content=<a href='/topic/show?id=6fb0521e42a' target=_blank style='color:#2F92EE;'>#急性下消化道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52174, encryptionId=6fb0521e42a, topicName=急性下消化道出血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14f431139253, createdName=zengjiayao, createdTime=Fri Nov 08 03:04:00 CST 2019, time=2019-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072712, encodeId=563620e27124f, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Feb 07 14:04:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262131, encodeId=b8f81262131a3, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446544, encodeId=0fef14465440c, content=<a href='/topic/show?id=4a672015341' target=_blank style='color:#2F92EE;'>#下消化道出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20153, encryptionId=4a672015341, topicName=下消化道出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=65305226247, createdName=bioon3, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464629, encodeId=473d146462931, content=<a href='/topic/show?id=32e765e6591' target=_blank style='color:#2F92EE;'>#消化道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65765, encryptionId=32e765e6591, topicName=消化道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7b6e6676048, createdName=changhe715, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504790, encodeId=c7e81504e90a3, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
    2020-02-07 许安
  7. 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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Feb 07 14:04:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262131, encodeId=b8f81262131a3, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446544, encodeId=0fef14465440c, content=<a href='/topic/show?id=4a672015341' target=_blank style='color:#2F92EE;'>#下消化道出血#</a>, beContent=null, 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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
  8. 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GetPortalCommentsPageByObjectIdResponse(id=2064841, encodeId=87a82064841f3, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Tue Aug 18 10:04:00 CST 2020, time=2020-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1692077, encodeId=45bf16920e7c2, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Feb 07 14:04:00 CST 2020, time=2020-02-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262131, encodeId=b8f81262131a3, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446544, encodeId=0fef14465440c, content=<a href='/topic/show?id=4a672015341' target=_blank style='color:#2F92EE;'>#下消化道出血#</a>, beContent=null, 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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
  9. 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content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Tue Oct 01 11:04:00 CST 2019, time=2019-10-01, status=1, ipAttribution=)]
  10. 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