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[非静脉曲张性上消化道出血]

[Non-Variceal Upper Gastrointestinal Bleeding].

作者信息

Yoon Dong Jin, Kim Joon Sung

出版信息

Korean J Helicobacter Up Gastrointest Res. 2024 Mar;24(1):16-23. doi: 10.7704/kjhugr.2024.0004. Epub 2024 Mar 8.

Abstract

Non-variceal upper gastrointestinal bleeding (NVUGIB), which predominantly occurs secondary to peptic ulcers, presents a major challenge in emergency departments and is associated with high mortality rates. The staged approach used for management of NVUGIB comprises preendoscopy, endoscopy, and post-endoscopy. Proton pump inhibitors and prokinetics are used for pre-endoscopy preparation to improve visualization and outcomes. Various endoscopic hemostatic methods, including injection therapy, clipping, and thermal techniques are described, which reflects the need for personalized strategies based on patient conditions and lesion characteristics. Post-endoscopic care includes continuous acid suppression therapy and selective second-look endoscopy. Overall, the approach to effective NVUGIB management is tailored to individual clinical scenarios to optimize patient outcomes.

摘要

非静脉曲张性上消化道出血(NVUGIB)主要继发于消化性溃疡,是急诊科面临的一项重大挑战,且死亡率很高。用于NVUGIB管理的分阶段方法包括内镜检查前、内镜检查和内镜检查后。质子泵抑制剂和促动力药用于内镜检查前准备,以改善视野和治疗效果。描述了各种内镜止血方法,包括注射疗法、夹子夹闭和热技术,这反映了需要根据患者情况和病变特征制定个性化策略。内镜检查后的护理包括持续的抑酸治疗和选择性的二次内镜检查。总体而言,有效的NVUGIB管理方法是根据个体临床情况量身定制的,以优化患者的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89a2/11967527/75e3563cf514/kjhugr-2024-0004f1.jpg

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