Rodriguez Moranta Francisco, Berrozpe Ana, Guardiola Jordi
Servicio de Gastroneterología, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, España.
Gastroenterol Hepatol. 2011 Oct;34(8):551-7. doi: 10.1016/j.gastrohep.2011.06.003. Epub 2011 Aug 31.
Lower gastrointestinal bleeding is a common medical emergency that usually has a favorable prognosis. However, these events generate high resource use. The procedure of choice is colonoscopy with prior colonic preparation due to its high diagnostic performance and safety and the possibility of endoscopic therapy. Emergency colonoscopy has advantages over elective colonoscopy, showing higher diagnostic yield and superior detection of stigmata of recent bleeding, increasing the probability of endoscopic treatment. Predictive models of bleeding severity and recurrence have been published, allowing resource use to be rationalized, mainly by reducing hospital stay in low-risk patients. Nevertheless, the optimal timing of emergency colonoscopy has not been established and the impact of endoscopic treatment on prognosis is controversial.
下消化道出血是一种常见的医疗急症,通常预后良好。然而,这些情况会导致大量资源的使用。由于结肠镜检查具有较高的诊断性能和安全性以及进行内镜治疗的可能性,因此首选的检查方法是在进行结肠准备后进行结肠镜检查。急诊结肠镜检查比择期结肠镜检查具有优势,其诊断率更高,对近期出血痕迹的检测更出色,从而增加了内镜治疗的可能性。已经发表了出血严重程度和复发的预测模型,主要通过缩短低风险患者的住院时间,使资源使用更加合理。然而,急诊结肠镜检查的最佳时机尚未确定,并且内镜治疗对预后的影响存在争议。