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儿童胃肠道出血:当前的处理方法、争议和进展。

Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances.

机构信息

Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY 10467, USA.

Division of Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Chicago, IL 60611, USA.

出版信息

Gastrointest Endosc Clin N Am. 2023 Apr;33(2):401-421. doi: 10.1016/j.giec.2022.11.003.

Abstract

Upper gastrointestinal bleeding (UGIB) in children has many causes, with its prevalence varying by age. Often presenting as hematemesis or melena, the initial treatment is stabilization of the patient, including protection of the airway, fluid resuscitation, and a transfusion hemoglobin threshold of 7 g/L. Endoscopy should be performed with the goal of using combinations of therapies to treat a bleeding lesion, generally involving epinephrine injection along with either cautery, hemoclips, or hemospray. This review discusses the diagnosis and treatment of variceal and non-variceal gastrointestinal bleeding in children with a focus on current advances in the treatment of severe UGIB.

摘要

儿童上消化道出血(UGIB)有多种病因,其发病率随年龄而异。常表现为呕血或黑便,初始治疗为稳定患者病情,包括保护气道、液体复苏和输血血红蛋白阈值为 7g/L。应进行内镜检查,目的是使用联合治疗方法治疗出血病变,通常包括肾上腺素注射,同时使用电烙术、止血夹或止血喷涂。本文综述了儿童胃食管静脉曲张和非静脉曲张性胃肠道出血的诊断和治疗,重点介绍了严重 UGIB 治疗方面的最新进展。

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