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呼吸机辅助急诊内镜在肝硬化合并食管胃静脉曲张出血治疗中的干预效果

Intervention effect of ventilator‑assisted emergency endoscopy in the treatment of cirrhosis‑associated esophagogastric variceal bleeding.

作者信息

Wu Xiu-Lian, Gu Yanmei, Wang Wenhui, Wei Jiayuan, Sun Xiaoqing, Hu Wenyue, He Wenhui

机构信息

Department of Intensive Care Medicine, Beijing You'an Hospital, Capital Medical University, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Nov 7;19(4):436-441. doi: 10.20452/wiitm.2024.17908. eCollection 2024 Dec 27.

Abstract

INTRODUCTION

Emergency endoscopy has proven remarkably effective in the treatment of gastrotestinal bleeding. However, its efficacy has not been extensively evaluated specifically in patients with cirrhosis‑associated esophagogastric variceal bleeding (EGVB). The patients may experience stress and anxiety before being subjected to the procedure.

AIM

This study aimed to investigate the effect of ventilator‑assisted emergency endoscopy in the treatment of cirrhosis‑associated EGVB.

MATERIALS AND METHODS

A total of 63 patients with cirrhosis‑associated EGVB were enrolled in the study and divided into 2 groups using the random number table method. The control group (n = 31) received conventional emergency endoscopic hemostasis, while the observational group (n = 32) underwent ventilator‑assisted emergency endoscopic hemostasis. The hemostatic success rate, post‑treatment rebleeding rate, postoperative complication rate, length of stay in the intensive care unit (ICU), cost of hospitalization, and the patients' feeling of comfort (eg, fever and anxiety) were assessed in both groups.

RESULTS

There were no significant differences in the hemostatic success rate, rebleeding rate, mortality, length of stay in the ICU, or cost of hospitalization between the groups. The symptoms and feelings of anxiety and pain in the observational group were significantly less intense than in the control group. However, there was no significant difference in the frequency of postoperative fever between the groups.

CONCLUSIONS

In the emergency endoscopic treatment of patients with cirrhosis‑associated EGVB, using a ventilator ensures a smooth airway, keeps patients sedated throughout the procedure, and enhances their overall comfort. Ventilator‑assisted emergency endoscopy helps alleviate postoperative pain and reduces anxiety.

摘要

引言

急诊内镜检查已被证明在治疗胃肠道出血方面非常有效。然而,其疗效尚未在肝硬化相关性食管胃静脉曲张出血(EGVB)患者中得到广泛的专门评估。患者在接受该手术前可能会经历压力和焦虑。

目的

本研究旨在探讨呼吸机辅助急诊内镜检查在治疗肝硬化相关性EGVB中的效果。

材料与方法

共有63例肝硬化相关性EGVB患者纳入本研究,并采用随机数字表法分为2组。对照组(n = 31)接受常规急诊内镜止血,而观察组(n = 32)接受呼吸机辅助急诊内镜止血。评估两组的止血成功率、治疗后再出血率、术后并发症发生率、重症监护病房(ICU)住院时间、住院费用以及患者的舒适度(如发热和焦虑)。

结果

两组在止血成功率、再出血率、死亡率、ICU住院时间或住院费用方面无显著差异。观察组的焦虑和疼痛症状及感受明显轻于对照组。然而,两组术后发热频率无显著差异。

结论

在肝硬化相关性EGVB患者的急诊内镜治疗中,使用呼吸机可确保气道通畅,使患者在整个手术过程中保持镇静,并提高其整体舒适度。呼吸机辅助急诊内镜检查有助于减轻术后疼痛并减少焦虑。

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