Upper gastrointestinal(GI)hemorrhage presents a substantial clinical challenge.Initial management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for hi...Upper gastrointestinal(GI)hemorrhage presents a substantial clinical challenge.Initial management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for high-risk patients is debated.Treatment goals include stopping acute bleeding,preventing rebleeding,and using a multimodal approach encompassing endoscopic,pharmacological,angiographic,and surgical methods.Pharmacological agents such as vasopressin,prostaglandins,and proton pump inhibitors are effective,but the increase in antithrombotic use has increased GI bleeding morbidity.Endoscopic hemostasis,particularly for nonvariceal bleeding,employs techniques such as electrocoagu-lation and heater probes,with concerns over tissue injury from monopolar electrocoagulation.Novel methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have limitations.Currently,the first-line therapy includes thermal probes and hemoclips,with over-the-scope clips emerging for larger ulcer bleeding.The gold probe,combining bipolar electrocoagulation and injection,offers targeted coagulation but has faced device-related issues.Future advancements involve combining techniques and improving endoscopic imaging,with studies exploring combined approaches showing promise.Ongoing research is crucial for developing standardized and effective hemorrhage management strategies.展开更多
Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this...Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.展开更多
AIM:To compare the effectiveness of argon plasma coagulation (APC) and heater probe coagulation (HPC) in non-variceal upper gastrointestinal bleeding.METHODS:Eighty-five (18 female,67 male) patients admitted for acute...AIM:To compare the effectiveness of argon plasma coagulation (APC) and heater probe coagulation (HPC) in non-variceal upper gastrointestinal bleeding.METHODS:Eighty-five (18 female,67 male) patients admitted for acute gastrointestinal bleeding due to gastric or duodenal ulcer were included in the study.Upper endoscopy was performed and HPC or APC were chosen randomly to stop the bleeding.Initial hemostasis and rebleeding rates were primary and secondary end-points of the study.RESULTS:Initial hemostasis was achieved in 97.7% (42/43) and 81% (36/42) of the APC and HPC groups,respectively (P < 0.05).Rebleeding rates were 2.4% (1/42) and 8.3% (3/36) in the APC and HPC groups,respectively,at 4 wk (P > 0.05).CONCLUSION:APC is an effective hemostatic method in bleeding peptic ulcers.Larger multicenter trials are necessary to confirm these results.展开更多
We investigated 2668 patients with non-variceal upper gastrointestinal bleeding and 660 patients with lower gastrointestinal bleeding treated between 1987 and 2011 in our hospital. Upper gastrointestinal bleeding was ...We investigated 2668 patients with non-variceal upper gastrointestinal bleeding and 660 patients with lower gastrointestinal bleeding treated between 1987 and 2011 in our hospital. Upper gastrointestinal bleeding was associated with gastric ulcer, duodenal ulcer, Mallory-Weiss syndrome, esophageal disease, and others. Endoscopic hemostasis was performed in approximately 67% of all cases with upper gastrointestinal bleeding and approximately 90% of cases with ulcer. The hemostasis success rate was over 90% for ulcer bleeding, and was also generally high for other diseases. The total number of patients with lower gastrointestinal bleeding was lower, with it being approximately 20% of those with upper gastrointestinal bleeding. Endoscopic hemostasis was performed in approximately 30% of the patients with lower gastrointestinal bleeding. The hemostasis success rate was generally high, but treatment switch to surgery or interventional radiology (IVR) was observed in some cases with colorectal diverticular bleeding.展开更多
目的:应用不同龈壁处理方式及成形系统对龈下深龋行邻面边缘提升术,观察充填后对牙周探诊出血的影响,为龈下深龋充填提供参考。方法:将36例龈下深龋病例分别采用排龈术、电刀切龈术、翻瓣术,将龈下缺损提升至龈上,完成复合树脂直接充填...目的:应用不同龈壁处理方式及成形系统对龈下深龋行邻面边缘提升术,观察充填后对牙周探诊出血的影响,为龈下深龋充填提供参考。方法:将36例龈下深龋病例分别采用排龈术、电刀切龈术、翻瓣术,将龈下缺损提升至龈上,完成复合树脂直接充填。术后3个月复查牙周探诊出血(bleeding on probing,BOP)。通过单因素分析及最优标度初步判断性别、年龄、牙齿类型、成形片种类、牙髓活力、处理方式对BOP的影响,建立非条件Logistic回归模型筛选影响BOP的因素。结果:成形片种类影响BOP(P=0.009),个性化修剪的Ivory型成形片比分段式成形片的探诊出血率高。年龄、性别、牙齿类型、牙髓活力及处理方式对BOP均无显著影响(P>0.05)。结论:成形片种类影响BOP,排龈术、电刀切龈术、翻瓣术3种龈壁暴露技术未对BOP造成明显影响。展开更多
文摘Upper gastrointestinal(GI)hemorrhage presents a substantial clinical challenge.Initial management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for high-risk patients is debated.Treatment goals include stopping acute bleeding,preventing rebleeding,and using a multimodal approach encompassing endoscopic,pharmacological,angiographic,and surgical methods.Pharmacological agents such as vasopressin,prostaglandins,and proton pump inhibitors are effective,but the increase in antithrombotic use has increased GI bleeding morbidity.Endoscopic hemostasis,particularly for nonvariceal bleeding,employs techniques such as electrocoagu-lation and heater probes,with concerns over tissue injury from monopolar electrocoagulation.Novel methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have limitations.Currently,the first-line therapy includes thermal probes and hemoclips,with over-the-scope clips emerging for larger ulcer bleeding.The gold probe,combining bipolar electrocoagulation and injection,offers targeted coagulation but has faced device-related issues.Future advancements involve combining techniques and improving endoscopic imaging,with studies exploring combined approaches showing promise.Ongoing research is crucial for developing standardized and effective hemorrhage management strategies.
文摘Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.
文摘AIM:To compare the effectiveness of argon plasma coagulation (APC) and heater probe coagulation (HPC) in non-variceal upper gastrointestinal bleeding.METHODS:Eighty-five (18 female,67 male) patients admitted for acute gastrointestinal bleeding due to gastric or duodenal ulcer were included in the study.Upper endoscopy was performed and HPC or APC were chosen randomly to stop the bleeding.Initial hemostasis and rebleeding rates were primary and secondary end-points of the study.RESULTS:Initial hemostasis was achieved in 97.7% (42/43) and 81% (36/42) of the APC and HPC groups,respectively (P < 0.05).Rebleeding rates were 2.4% (1/42) and 8.3% (3/36) in the APC and HPC groups,respectively,at 4 wk (P > 0.05).CONCLUSION:APC is an effective hemostatic method in bleeding peptic ulcers.Larger multicenter trials are necessary to confirm these results.
文摘We investigated 2668 patients with non-variceal upper gastrointestinal bleeding and 660 patients with lower gastrointestinal bleeding treated between 1987 and 2011 in our hospital. Upper gastrointestinal bleeding was associated with gastric ulcer, duodenal ulcer, Mallory-Weiss syndrome, esophageal disease, and others. Endoscopic hemostasis was performed in approximately 67% of all cases with upper gastrointestinal bleeding and approximately 90% of cases with ulcer. The hemostasis success rate was over 90% for ulcer bleeding, and was also generally high for other diseases. The total number of patients with lower gastrointestinal bleeding was lower, with it being approximately 20% of those with upper gastrointestinal bleeding. Endoscopic hemostasis was performed in approximately 30% of the patients with lower gastrointestinal bleeding. The hemostasis success rate was generally high, but treatment switch to surgery or interventional radiology (IVR) was observed in some cases with colorectal diverticular bleeding.
文摘目的:应用不同龈壁处理方式及成形系统对龈下深龋行邻面边缘提升术,观察充填后对牙周探诊出血的影响,为龈下深龋充填提供参考。方法:将36例龈下深龋病例分别采用排龈术、电刀切龈术、翻瓣术,将龈下缺损提升至龈上,完成复合树脂直接充填。术后3个月复查牙周探诊出血(bleeding on probing,BOP)。通过单因素分析及最优标度初步判断性别、年龄、牙齿类型、成形片种类、牙髓活力、处理方式对BOP的影响,建立非条件Logistic回归模型筛选影响BOP的因素。结果:成形片种类影响BOP(P=0.009),个性化修剪的Ivory型成形片比分段式成形片的探诊出血率高。年龄、性别、牙齿类型、牙髓活力及处理方式对BOP均无显著影响(P>0.05)。结论:成形片种类影响BOP,排龈术、电刀切龈术、翻瓣术3种龈壁暴露技术未对BOP造成明显影响。