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射频消融治疗胃窦血管扩张症

Radiofrequency ablation for the treatment of gastric antral vascular ectasia.

作者信息

Dray Xavier, Repici Alessandro, Gonzalez Pedro, Fristrup Claus, Lecleire Stéphane, Kantsevoy Sergey, Wengrower Dov, Elbe Peter, Camus Marine, Carlino Alessandra, Pérez-Roldán Francisco, Adar Tomer, Marteau Philippe

机构信息

APHP Lariboisière Hospital and Sorbonne Paris Cité Paris 7 University, Paris, France.

Istituto Clinico Humanitas, Milano, Italy.

出版信息

Endoscopy. 2014 Nov;46(11):963-9. doi: 10.1055/s-0034-1377695. Epub 2014 Aug 11.

Abstract

BACKGROUND AND STUDY AIMS

The traditional endoscopic treatment for gastric antral vascular ectasia (GAVE) is argon plasma coagulation, but results are not always positive. Radiofrequency ablation (RFA) is a new endoscopic therapy that may be an attractive option for the treatment of GAVE. The aim of this study was to assess the efficacy and safety of RFA for the treatment of GAVE.

PATIENTS AND METHODS

This was an open-label, retrospective, case series study. The main outcome measures were number of red blood cell (RBC) packs transfused (transfusion requirement) and hemoglobin concentrations (g/dL) in the 6 months prior to and after RFA. Success was defined as a decrease in transfusion requirement in the 6 months after RFA compared with before treatment.

RESULTS

A total of 24 patients underwent a mean of 1.8 ± 0.8 RFA sessions. No complications were reported. One patient was referred for additional argon plasma coagulation during follow-up. The mean number of RBC packs decreased in all 23 transfusion-dependent patients, from a mean of 10.6 ± 12.1 during the 6 months prior to RFA, to a mean of 2.5 ± 5.9 during the 6 months after RFA treatment (P < 0.001), and 15 patients (65.2 %) were weaned off transfusions completely. An increase in the hemoglobin concentration was reported in all patients after RFA (from 6.8 ± 1.4 g/dL to 9.8 ± 1.8 g/dL; P < 0.001).

CONCLUSION

RFA for the treatment of GAVE seems feasible and safe, and significantly reduced the need for RBC transfusion and increased the hemoglobin level in this retrospective case series.

摘要

背景与研究目的

胃窦血管扩张症(GAVE)的传统内镜治疗方法是氩离子凝固术,但效果并非总是理想。射频消融术(RFA)是一种新的内镜治疗方法,可能是治疗GAVE的一个有吸引力的选择。本研究的目的是评估RFA治疗GAVE的疗效和安全性。

患者与方法

这是一项开放标签的回顾性病例系列研究。主要观察指标为RFA治疗前后6个月内输注红细胞(RBC)包的数量(输血需求)和血红蛋白浓度(g/dL)。成功定义为RFA治疗后6个月内输血需求较治疗前减少。

结果

共有24例患者平均接受了1.8±0.8次RFA治疗。未报告并发症。1例患者在随访期间接受了额外的氩离子凝固术。在所有23例依赖输血的患者中,RBC包的平均数量减少,从RFA治疗前6个月的平均10.6±12.1降至RFA治疗后6个月的平均2.5±5.9(P<0.001),15例患者(65.2%)完全停止输血。所有患者RFA治疗后血红蛋白浓度均升高(从6.8±1.4 g/dL升至9.8±1.8 g/dL;P<0.001)。

结论

在这个回顾性病例系列中,RFA治疗GAVE似乎可行且安全,显著减少了RBC输血需求并提高了血红蛋白水平。

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