Hansen Frederik Elbke, Ploug Magnus, Jørgensen Gitte Maria, Karstensen John Gásdal, de Muckadell Ove B Schaffalitzky, Laursen Stig Borbjerg
Afdeling for Medicinske Mavetarmsygdomme S, Odense Universitetshospital.
Kirurgisk Afdeling, Syddansk Universitetshospital - Esbjerg Sygehus.
Ugeskr Laeger. 2024 Aug 26;186(35):V04240254. doi: 10.61409/V04240254.
This review evaluates the evidence for the use of over-the-scope clips (OTSC), topical haemostatic agents (THA), and prophylactic embolisation (PE) in patients with peptic ulcer bleeding (PUB). The use of OTSC and THA may have the potential to increase the rate of endoscopic haemostasis in PUB not responding to conventional endoscopic treatment. In patients at high risk of recurrent bleeding, the performance of PE after achieving endoscopic haemostasis can reduce the risk of rebleeding and the need for surgery. Implementation of a local treatment protocol including these modalities may improve patient outcomes.
本综述评估了在消化性溃疡出血(PUB)患者中使用套扎器(OTSC)、局部止血剂(THA)和预防性栓塞(PE)的证据。对于对传统内镜治疗无反应的PUB患者,使用OTSC和THA可能有提高内镜止血率的潜力。在再出血高危患者中,内镜止血后进行PE可降低再出血风险及手术需求。实施包括这些方式的局部治疗方案可能改善患者预后。