设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

小肠杜氏病(Dieulafoy)病变出血:一项关于流行病学和肠镜治疗效能的系统研究

发布日期:2014-1-29 12:40:19 文章来源:GIE 作者次数:1092
    背景
    杜氏病(Dieulafoy)病变包括异常粘膜下动脉,可引起严重的胃肠道出血。杜氏病(Dieulafoy)病变部位主要是在上消化道。
    目的
    据我们所知,这是第一次关于小肠上杜氏病Dieulafoy)病变引发出血频率和关于初期止血和长期随访的肠镜治疗效能系统研究。
    设计
    环境
    九所奥地利中心进行双气囊肠镜或单气囊肠镜检查
    患者
    这项研究有284例患者参加,这些患者由于疑似中消化道出血而接受双气囊肠镜或单气囊肠镜检查。
    干预
    对284例疑似中消化道出血患者共实施317个双气囊肠镜和78个单气囊肠镜手术。
    主要测量指标
    收集人口统计数据、临床数据、手术程序上的数据和结果数据。
    结果
    本研究结果确定有3.5%的患者因患小肠上杜氏病(Dieulafoy)病变而导致中消化道出血,每次诊断要求平均1.5肠镜检查过程。经口进镜检查发现9例患有杜氏病(Dieulafoy)病变,同时经肛进镜检查发现1例有杜氏病(Dieulafoy)病变。对所有患者都成功进行了內镜下初期止血。10例患者中有8例无再出血发生(中位随访时间为14.5个月,四分位距为10.0-17.5个月)。10例中有2例发生再出血,故需要外科手术治疗。
    局限性
    回顾性研究。
    结论
    小肠上杜氏病(Dieulafoy)病变出血看起来比之前估计的更频繁。多数病变发生在空肠近端,因此能被肠镜成功治疗。內镜下成功止血后仅有20%的患者发生再出血。
    缩写词 DBE双气囊肠镜DL为杜氏病病变,SBE为单气囊肠镜。
     
    ---------------------------------------------------------------------------------------------------------------------
    Bleeding Dieulafoy lesions of the small bowel: a systematic study on the epidemiology and efficacy of enteroscopic treatment
    Background
    Dieulafoy lesions consist of aberrant submucosal arteries, which can cause severe GI bleeding. The predominant location of Dieulafoy lesions is the upper GI tract.
    Objective
    To our best knowledge, this is the first systematic study on the frequency of bleeding from Dieulafoy lesions in the small bowel and the efficacy of enteroscopic therapy regarding primary hemostasis and long-term follow-up.
    Design
    Multicenter, retrospective, observational study.
    Setting
    Nine Austrian centers doing double-balloon enteroscopy or single-balloon enteroscopy.
    Patients
    This study involved 284 consecutive patients who were referred for double-balloon enteroscopy or single-balloon enteroscopy because of suspicion of mid-GI bleeding.
    Intervention
    A total of 317 double-balloon enteroscopy and 78 single-balloon enteroscopy procedures were performed in 284 patients with suspected mid-GI bleeding.
    Main Outcome Measurements
    Demographic, clinical, procedural, and outcome data were collected.
    Results
    A Dieulafoy lesion in the small bowel was identified as the source of mid-GI bleeding in 3.5% of patients, with a mean of 1.5 enteroscopy sessions required per diagnosis. In 9 cases the Dieulafoy lesion was found by enteroscopy from an oral approach, and in 1 patient the lesion was found by an anal approach. In all patients primary endoscopic hemostasis was successful. Eight of 10 patients were free from rebleeding episodes (median follow-up 14.5 months, interquartile range 10.0-17.5 months). In 2 of 10 patients, rebleeding occurred, and a surgical intervention was necessary.
    Limitations
    Retrospective study.
    Conclusion
    Bleeding from Dieulafoy lesions of the small bowel seems to occur more frequently than previously estimated. Most of these lesions are located in the proximal jejunum and can be managed successfully by enteroscopy. After successful endoscopic hemostasis, rebleeding episodes occur in only 20% of patients.
     
     
    (作者:)
相关评论
用户名: 登录