Department of Gastroenterology, Ondokuz Mayis University, School of Medicine, Samsun, Turkey.
Medicine (Baltimore). 2024 May 31;103(22):e38319. doi: 10.1097/MD.0000000000038319.
The Ankaferd Blood Stopper (ABS) proves effective in managing various bleedings, particularly in surgical and dental procedures. This study assesses ABS efficacy endoscopically by less-experienced endoscopists for non-variceal upper gastrointestinal bleeding (NVUGB). Between 2016 and 2021, our hospital's Gastroenterology Department Endoscopy Unit conducted a retrospective data analysis of 653 patients who underwent endoscopy for NVUGB. The study included 202 patients who underwent endoscopic interventions performed by endoscopists with less than 3 years of experience. Based on the method used for endoscopic hemostasis, we classified those treated with ABS (either alone or as a second method) as group 1. In contrast, we classified patients treated with non-ABS hemostatic methods into Group 2. The study included 202 patients, with 96 (47.52%) in Group 1 and 106 (52.48%) in Group 2. All patients in Group 1 achieved bleeding control, while 4 patients in Group 2 initially did not achieve bleeding control; however, bleeding control was subsequently established following ABS administration. After 1 month of follow-up, mortality occurred in 3 out of 202 patients (1.48%), and all these cases were in Group 2. There is a significant difference in the need for blood transfusion between the groups (P < .001). Regarding the bleeding source, bulbus ulcer and gastric cancer were more prevalent in Group 2. On the other hand, although statistical significance was not reached in the comparison of rebleeding rates between groups, numerically, a higher incidence of recurrent bleeding was observed in Group 2 (Group 1: 3 [3.1%], Group 2: 8 [7.5%]; P = .167). Additionally, a similar relationship was noted among intensive care admissions (Group 1: 5 [5.2%]; Group 2: 7 [6.6%]; P = .675). In the group that used ABS, there were significantly higher rates of hypotension, tachycardia, syncope, and the need for transfusion than in the other group. In medical practice, this distinction often stems from the shared preference of clinicians to use ABS as a salvage method in cases of more severe bleeding. Considering all the findings, it is evident that using ABS through endoscopy in cases of NVUGIB significantly improves procedural success, irrespective of the endoscopist's experience level.
安卡福（Ankaferd）止血粉在处理各种出血方面具有显著效果，尤其在外科和牙科手术中。本研究通过经验相对不足的内镜医生进行内镜评估，以确定安卡福（Ankaferd）止血粉对非静脉曲张性上消化道出血（NVUGB）的疗效。2016 年至 2021 年期间，我院消化内科内镜室对 653 例行内镜检查的 NVUGB 患者进行了回顾性数据分析。该研究纳入了 202 例行内镜治疗的患者，其内镜治疗由经验不足 3 年的内镜医生实施。根据内镜止血方法，我们将使用安卡福（Ankaferd）止血粉（单独使用或作为第二种方法）的患者分为 1 组。相反，我们将使用非安卡福（Ankaferd）止血方法的患者分为 2 组。该研究共纳入 202 例患者，其中 96 例（47.52%）为 1 组，106 例（52.48%）为 2 组。1 组所有患者均达到止血，而 2 组中有 4 例患者最初未达到止血，但随后给予安卡福（Ankaferd）止血粉后成功止血。在 1 个月的随访中，202 例患者中有 3 例（1.48%）死亡，且均来自 2 组。两组间输血需求存在显著差异（P<0.001）。关于出血源，2 组中球部溃疡和胃癌更为常见。另一方面，尽管组间再出血率的比较未达到统计学意义，但数值上 2 组中再出血发生率更高（1 组：3[3.1%]例，2 组：8[7.5%]例；P=0.167）。同样，重症监护病房收治率也存在类似关系（1 组：5[5.2%]例，2 组：7[6.6%]例；P=0.675）。在使用安卡福（Ankaferd）止血粉的组中，低血压、心动过速、晕厥和输血需求的发生率明显高于另一组。在医疗实践中，这种差异通常源于临床医生更倾向于将安卡福（Ankaferd）止血粉作为严重出血情况下的抢救方法。综合所有发现，对于 NVUGIB，通过内镜使用安卡福（Ankaferd）止血粉可显著提高手术成功率，而与内镜医生的经验水平无关。
