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超声引导下经皮注射凝血酶治疗经皮内镜下胃造口术（PEG）置管后造口部位出血：病例系列及文献复习

Ultrasound (US)-guided percutaneous thrombin injection for stoma-site bleeding after PEG tube insertion: a case series and review of the literature.

作者信息

Alfahad Aws, Alhalabi Rawan

机构信息

American Hospital Dubai, Dubai, UAE.

出版信息

CVIR Endovasc. 2024 Feb 20;7(1):20. doi: 10.1186/s42155-024-00432-y.

DOI:10.1186/s42155-024-00432-y
PMID:38376801
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10879047/
Abstract

BACKGROUND

Post-gastrostomy bleeding sequelae are acknowledged, with reported approaches focusing on conservative measures or surgical repair. Nonetheless, Percutaneous Thrombin Injections (PTI) role in PEG-site-related bleeding remains underexplored. PTI under ultrasound guidance is an advocated management strategy for stoma-site bleeding following gastrostomy in high-risk patients, particularly those on direct oral anticoagulants.

CASE PRESENTATION

This study presents three cases with multiple comorbidities who underwent PTI. Resulting in immediate resolution of bleeding, no systemic\local effect, and no reported complications or rebleeding after a 3-6-month follow-up.

CONCLUSION

The findings highlight the safety, direct complete resolution, and absence of sequelae associated with PTI, suggesting its potential as a promising technique in managing PEG stoma-related bleeding.

摘要

背景

胃造口术后出血后遗症是公认的，报道的治疗方法主要集中在保守措施或手术修复上。然而，经皮凝血酶注射（PTI）在经皮内镜下胃造口术（PEG）相关出血中的作用仍未得到充分研究。超声引导下的PTI是高危患者胃造口术后造口部位出血的一种推荐管理策略，尤其是那些正在接受直接口服抗凝剂治疗的患者。

病例报告

本研究介绍了3例患有多种合并症并接受PTI治疗的病例。出血立即得到解决，无全身/局部影响，在3至6个月的随访中未报告并发症或再出血。

结论

研究结果突出了PTI的安全性、直接完全止血效果以及无后遗症，表明其作为一种有前景的技术在处理PEG造口相关出血方面的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/a14c1635c8f7/42155_2024_432_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/75620adf03cb/42155_2024_432_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/163d4d9dd1de/42155_2024_432_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/b4c0737c2801/42155_2024_432_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/a14c1635c8f7/42155_2024_432_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/75620adf03cb/42155_2024_432_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/163d4d9dd1de/42155_2024_432_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/b4c0737c2801/42155_2024_432_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f54/10879047/a14c1635c8f7/42155_2024_432_Fig4_HTML.jpg

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