Haseeb Abdul, Freeman Martin L, Amateau Stuart K
Division of Gastroenterology and Hepatology, Department of Medicine, University of Minnesota Medical Center, Minneapolis, Minnesota, USA.
VideoGIE. 2019 Jun 10;4(8):386-388. doi: 10.1016/j.vgie.2019.04.010. eCollection 2019 Aug.
GI bleeding is a leading cause of morbidity and mortality in the United States, with an estimated 20,000 deaths per year. Some subgroups of patients show refractory recurrent bleeding despite standard endoscopic therapy. The U.S. Food and Drug Administration has recently approved a hemostatic spray for clinical use in nonvariceal bleeding. Despite its efficacy, not all endoscopy units have access to this spray, at times because of cost. Our aim was to determine the safety and efficacy of a plant-based hemostatic particle spray in nonvariceal GI bleeding by use of a cross-platform setup.
We present 3 cases in which plant-based particle spray was used for hemostasis with a cross-platform delivery system. Conventional therapies failed in the first 2 cases, and in the third case hemostatic particle spray was used as a primary therapy.
Successful immediate hemostasis was achieved in all 3 patients. No immediate adverse events or recurrence of bleeding was noted.
Plant-based hemostatic particle spray is safe and effective as a temporizing measure in refractory ulcer and postnecrosectomy cavity bleeding. Further studies are needed to establish the safety and comparative efficacy of plant-based hemostatic powder. The cross-platform system used here for plant-based hemostatic particle spray presents a less-expensive alternative in selected cases.
在美国，胃肠道出血是发病和死亡的主要原因之一，估计每年有20000人死亡。尽管采用了标准的内镜治疗，但一些患者亚组仍出现难治性复发性出血。美国食品药品监督管理局最近批准了一种用于非静脉曲张性出血临床治疗的止血喷雾剂。尽管其疗效显著，但有时由于成本问题，并非所有内镜科室都能使用这种喷雾剂。我们的目的是通过跨平台设置，确定一种植物基止血颗粒喷雾剂在非静脉曲张性胃肠道出血中的安全性和有效性。
我们报告3例使用植物基颗粒喷雾剂通过跨平台输送系统进行止血的病例。前2例传统治疗失败，第3例将止血颗粒喷雾剂作为主要治疗方法。
所有3例患者均立即成功止血。未观察到即时不良事件或出血复发。
植物基止血颗粒喷雾剂作为难治性溃疡和坏死组织切除术后腔隙出血的临时措施是安全有效的。需要进一步研究以确定植物基止血粉的安全性和比较疗效。本文用于植物基止血颗粒喷雾剂的跨平台系统在某些特定情况下提供了一种成本较低的选择。
