Sung Joseph J Y, Laine Loren, Kuipers Ernst J, Barkun Alan N
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
Section of Digestive Diseases, Yale School of Medicine and VA Connecticut Healthcare System, New Haven, Connecticut, USA.
Gut. 2021 May;70(5):818-824. doi: 10.1136/gutjnl-2020-323846. Epub 2021 Mar 1.
Guidelines from national and international professional societies on upper gastrointestinal bleeding highlight the important clinical issues but do not always identify specific management strategies pertaining to individual patients. Optimal treatment should consider the personal needs of an individual patient and the pertinent resources and experience available at the point of care. This article integrates international guidelines and consensus into three stages of management: pre-endoscopic assessment and treatment, endoscopic evaluation and haemostasis and postendoscopic management. We emphasise the need for personalised management strategies based on patient characteristics, nature of bleeding lesions and the clinical setting including available resources.
国家和国际专业学会关于上消化道出血的指南突出了重要的临床问题，但并不总是能确定针对个体患者的具体管理策略。最佳治疗应考虑个体患者的个人需求以及医疗现场可用的相关资源和经验。本文将国际指南和共识整合到管理的三个阶段：内镜检查前评估与治疗、内镜评估与止血以及内镜检查后管理。我们强调需要根据患者特征、出血病变的性质以及包括可用资源在内的临床情况制定个性化的管理策略。
