Parsi Mansour A, Schulman Allison R, Aslanian Harry R, Bhutani Manoop S, Krishnan Kuman, Lichtenstein David R, Melson Joshua, Navaneethan Udayakumar, Pannala Rahul, Sethi Amrita, Trikudanathan Guru, Trindade Arvind J, Watson Rabindra R, Maple John T
Section for Gastroenterology & Hepatology, Tulane University Health Sciences Center, New Orleans, LA.
Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI.
VideoGIE. 2019 Jun 27;4(7):285-299. doi: 10.1016/j.vgie.2019.02.004. eCollection 2019 Jul.
Endoscopic intervention is often the first line of therapy for GI nonvariceal bleeding. Although some of the devices and techniques used for this purpose have been well studied, others are relatively new, with few available outcomes data.
In this document, we review devices and techniques for endoscopic treatment of nonvariceal GI bleeding, the evidence regarding their efficacy and safety, and financial considerations for their use.
Devices used for endoscopic hemostasis in the GI tract can be classified into injection devices (needles), thermal devices (multipolar/bipolar probes, hemostatic forceps, heater probe, argon plasma coagulation, radiofrequency ablation, and cryotherapy), mechanical devices (clips, suturing devices, banding devices, stents), and topical devices (hemostatic sprays).
Endoscopic evaluation and treatment remains a cornerstone in the management of nonvariceal upper- and lower-GI bleeding. A variety of devices is available for hemostasis of bleeding lesions in the GI tract. Other than injection therapy, which should not be used as monotherapy, there are few compelling data that strongly favor any one device over another. For endoscopists, the choice of a hemostatic device should depend on the type and location of the bleeding lesion, the availability of equipment and expertise, and the cost of the device.
内镜干预通常是胃肠道非静脉曲张性出血的一线治疗方法。尽管用于此目的的一些设备和技术已得到充分研究，但其他一些则相对较新，可用的疗效数据较少。
在本文中，我们回顾了用于内镜治疗非静脉曲张性胃肠道出血的设备和技术、关于其疗效和安全性的证据以及使用它们的财务考量。
用于胃肠道内镜止血的设备可分为注射设备（针）、热设备（多极/双极探头、止血钳、热探头、氩等离子体凝固、射频消融和冷冻疗法）、机械设备（夹子、缝合设备、套扎设备、支架）和局部设备（止血喷雾）。
内镜评估和治疗仍然是胃肠道非静脉曲张性上、下消化道出血管理的基石。有多种设备可用于胃肠道出血病变的止血。除了不应作为单一疗法使用的注射疗法外，几乎没有令人信服的数据强烈支持一种设备优于另一种设备。对于内镜医师而言，止血设备的选择应取决于出血病变的类型和位置、设备和专业知识的可用性以及设备成本。
