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本文引用的文献

1
Clinical Outcomes and Safety of Upper Endoscopy While on Glucagon-Like Peptide-1 Receptor Agonists.使用胰高血糖素样肽-1受体激动剂时进行上消化道内镜检查的临床结果与安全性
Clin Gastroenterol Hepatol. 2025 Apr;23(5):872-873.e3. doi: 10.1016/j.cgh.2024.03.013. Epub 2024 Apr 3.
2
ASA Consensus-based Guidance on Preoperative Management of Patients on Glucagon-like Peptide-1 Receptor Agonists.美国麻醉医师协会基于共识的胰高血糖素样肽-1受体激动剂治疗患者术前管理指南。
Anesthesiology. 2024 Feb 1;140(2):346-348. doi: 10.1097/ALN.0000000000004776.
3
AGA Rapid Clinical Practice Update on the Management of Patients Taking GLP-1 Receptor Agonists Prior to Endoscopy: Communication.AGA 关于在接受 GLP-1 受体激动剂治疗的患者行内镜检查前的管理的快速临床实践更新:沟通。
Clin Gastroenterol Hepatol. 2024 Apr;22(4):705-707. doi: 10.1016/j.cgh.2023.11.002. Epub 2023 Nov 7.
4
The Efficacy of GLP-1 Analogues on Appetite Parameters, Gastric Emptying, Food Preference and Taste Among Adults with Obesity: Systematic Review of Randomized Controlled Trials.GLP-1类似物对肥胖成年人食欲参数、胃排空、食物偏好和味觉的疗效:随机对照试验的系统评价
Diabetes Metab Syndr Obes. 2023 Mar 2;16:575-595. doi: 10.2147/DMSO.S387116. eCollection 2023.
5
Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration.术前禁食及使用药物降低肺误吸风险的实践指南:适用于接受择期手术的健康患者:美国麻醉医师协会术前禁食及使用药物降低肺误吸风险特别工作组的最新报告
Anesthesiology. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452.
6
Endoscopic Gastric Food Retention in Relation to Scintigraphic Gastric Emptying Delays and Clinical Factors.内镜下胃内食物潴留与放射性核素胃排空延迟及临床因素的关系
Dig Dis Sci. 2016 Sep;61(9):2593-601. doi: 10.1007/s10620-016-4173-7. Epub 2016 May 19.
7
Aspiration in the context of upper gastrointestinal endoscopy.上消化道内镜检查中的抽吸操作。
Can J Gastroenterol. 2007 Apr;21(4):223-5. doi: 10.1155/2007/307937.
8
Pulmonary aspiration after fibre-endoscopy of the upper gastrointestinal tract.上消化道纤维内镜检查后的肺误吸
Br Med J. 1972 Nov 4;4(5835):269-71. doi: 10.1136/bmj.4.5835.269.
9
Pulmonary aspiration during emergency endoscopy in patients with upper gastrointestinal hemorrhage.上消化道出血患者急诊内镜检查期间的肺误吸
Crit Care Med. 1991 Mar;19(3):330-3. doi: 10.1097/00003246-199103000-00008.

上消化道内镜检查期间胃肠道异物残留的结局

Outcomes of retained gastrointestinal debris during upper endoscopy.

作者信息

Jacob Jake Sheraj, Than Jeffrey, Tang Christine, Cano Joseph, Sheikh Rehman, Wolfson Sharon, Thrift Aaron P, Munnur Uma, Sealock Robert J

机构信息

Gastroenterology, Baylor College of Medicine, Houston, United States.

Internal Medicine, Northwestern University, Evanston, United States.

出版信息

Endosc Int Open. 2025 Apr 4;13:a25442468. doi: 10.1055/a-2544-2468. eCollection 2025.

DOI:10.1055/a-2544-2468
PMID:40230565
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11996021/
Abstract

BACKGROUND AND STUDY AIMS

Gastrointestinal debris retention (GIDR) during endoscopy can result in aborted procedures, intubation, and aspiration. GIDR has increased significance with uptake of glucagon-like peptide-1 receptor agonist (GLP-1RA) use. Outcome analysis is vital to risk-stratify patients with GIDR during endoscopy. Our study evaluated the effect of GIDR on endoscopic complications.

PATIENTS AND METHODS

This was a retrospective review of patients who underwent endoscopy between May 2016 and December 2021 with documented GIDR. The study included 138 patients with GIDR and 275 controls. Propensity score matching between patients with GIDR and controls was performed in a 1:2 ratio based on age, sex, body mass index (BMI), and American Society of Anesthesiologists (ASA) status. T-tests and chi square tests were used to compare continuous and categorical variables.

RESULTS

The GIDR group was younger and had lower BMI, with no difference in sex, race, American Society of Anesthesiologists status, or use of monitored anesthesia care. GIDR was more frequently encountered when indications were abnormal imaging, pain, and pancreatico-biliary. Amount of GIDR was quantified as "large" in 37.7% of cases and size of debris was associated with rate of aborted procedures.

CONCLUSIONS

Our study did not demonstrate a significant increase in post-procedure complications in patients with GIDR. Further, the GIDR group had higher rates of opiate use, which can guide stratification of retention risk.

摘要

背景与研究目的

内镜检查期间胃肠道残渣潴留(GIDR)可导致检查中断、插管和误吸。随着胰高血糖素样肽-1受体激动剂(GLP-1RA)使用的增加,GIDR的重要性日益凸显。结果分析对于内镜检查期间GIDR患者的风险分层至关重要。我们的研究评估了GIDR对内镜并发症的影响。

患者与方法

这是一项对2016年5月至2021年12月期间接受内镜检查且有GIDR记录患者的回顾性研究。该研究纳入了138例GIDR患者和275例对照。基于年龄、性别、体重指数(BMI)和美国麻醉医师协会(ASA)分级,对GIDR患者与对照进行了1:2比例的倾向评分匹配。采用t检验和卡方检验比较连续变量和分类变量。

结果

GIDR组患者更年轻,BMI更低,在性别、种族、美国麻醉医师协会分级或监护麻醉护理的使用方面无差异。当适应证为异常影像、疼痛和胰胆疾病时,GIDR更为常见。37.7%的病例中GIDR量被量化为“大量”,残渣大小与检查中断率相关。

结论

我们的研究未显示GIDR患者术后并发症有显著增加。此外,GIDR组阿片类药物使用率更高,这可指导对潴留风险进行分层。