前沿：多普勒探头在引导内镜止血中的应用
The Cutting Edge: Doppler Probe in Guiding Endoscopic Hemostasis.
作者信息
Ghassemi Kevin A, Jensen Dennis M
机构信息
Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 100 Medical Plaza Driveway, Los Angeles, CA 90095, USA; CURE: Digestive Diseases Research Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, 100 Medical Plaza Driveway, Los Angeles, CA 90095, USA; CURE: Digestive Diseases Research Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Department of Medicine, VA West Los Angeles Medical Center, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
出版信息
Gastrointest Endosc Clin N Am. 2018 Jul;28(3):321-330. doi: 10.1016/j.giec.2018.02.005.
This article examines use of the Doppler endoscopic probe (DEP) for risk stratification and as a guide to definitive hemostasis of nonvariceal upper gastrointestinal (NVUGI) bleeding and colonic diverticular hemorrhage. Studies report that lesions with high-risk stigmata of recent hemorrhage (SRH) have a higher rate of a positive DEP signal compared with those without such SRH. Lesions with a persistently positive DEP signal after endoscopic hemostasis have a higher 30-day rebleeding rate. Studies document arterial blood flow underneath stigmata of recent hemorrhage as a risk factor for rebleeding of focal nonvariceal gastrointestinal lesions. With DEP probe as a guide, rates of definitive endoscopic hemostasis and clinical outcomes are improved compared with standard visually guided treatment.
本文探讨了多普勒内镜探头（DEP）在非静脉曲张性上消化道（NVUGI）出血和结肠憩室出血的风险分层中的应用，以及作为确定性止血的指导工具。研究报告称，与无近期出血（SRH）高危征象的病变相比，有SRH高危征象的病变DEP信号阳性率更高。内镜止血后DEP信号持续阳性的病变30天再出血率更高。研究表明，近期出血征象下的动脉血流是局灶性非静脉曲张性胃肠道病变再出血的一个危险因素。与标准的视觉引导治疗相比，以DEP探头为指导，确定性内镜止血率和临床结局均有所改善。
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