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常规使用 Hemospray 治疗胃肠道出血:瑞士的前瞻性双中心经验。

Routine use of Hemospray for gastrointestinal bleeding: prospective two-center experience in Switzerland.

机构信息

Department of Gastroenterology and Hepatology, Kantonspital St. Gallen, Switzerland.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital of Zurich, Switzerland.

出版信息

Endoscopy. 2014 Jul;46(7):619-24. doi: 10.1055/s-0034-1365505. Epub 2014 Apr 25.

Abstract

Hemospray (Cook Medical, Winston-Salem, North Carolina, USA) is a hemostatic agent recently introduced for the management of upper gastrointestinal bleeding (GIB). To date, there is little experience with this fairly new hemostatic tool. The aim of this case series was to reflect the use and effectiveness of Hemospray as a treatment option in GIB in everyday clinical practice at two tertiary referral centers. Consecutive patients (n = 16) with active GIB of various origins were treated with Hemospray. The rate of successful initial hemostasis was 93.75 % (15 /16; salvage therapy 92.85 % [13/14]; monotherapy 100 % [2 /2]). The rebleeding rate within 7 days was 12.5 % (2/16). One patient, in whom interventional radiology also failed, had to undergo surgery as salvage therapy. The effectiveness of Hemospray in the management of GIB in various clinical situations is promising. Future multicenter randomized prospective trials for clearly defined bleeding situations are needed for greater generalizability of case series findings.

摘要

海莫沙普(库克医疗,北卡罗来纳州温斯顿-塞勒姆,美国)是一种最近被引入用于治疗上消化道出血(GIB)的止血剂。到目前为止,这种相当新的止血工具的经验还很少。本病例系列旨在反映在两个三级转诊中心的日常临床实践中,海莫沙普作为 GIB 治疗选择的使用情况和效果。连续(n=16)例不同来源的活动性 GIB 患者接受了海莫沙普治疗。初始止血成功率为 93.75%(15/16;挽救性治疗 92.85%[13/14];单一疗法 100%[2/2])。7 天内再出血率为 12.5%(2/16)。1 例患者介入放射治疗也失败,需要进行手术作为挽救性治疗。海莫沙普在各种临床情况下治疗 GIB 的效果是有希望的。需要进行明确出血情况的多中心随机前瞻性试验,以使病例系列结果具有更大的普遍性。

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