Hemostatic radiotherapy is a non-invasive treatment for bleeding gastrointestinal(GI)tumors,promoting tumor shrinkage,blood supply reduction,and fibrotic tissue formation.It is effective in cases where traditional int...Hemostatic radiotherapy is a non-invasive treatment for bleeding gastrointestinal(GI)tumors,promoting tumor shrinkage,blood supply reduction,and fibrotic tissue formation.It is effective in cases where traditional interventions are insufficient or contraindicated and can prevent recurrent bleeding in patients with GI bleeding histories.Hypofractionation schedules are also effective for tumor control and patient compliance.展开更多
BACKGROUND Endoscopic mucosal dissection has become the standard treatment for early gastric cancer.However,post-endoscopic submucosal dissection(ESD)ulcer occurs in 4.4%of patients.This study hypothesized whether app...BACKGROUND Endoscopic mucosal dissection has become the standard treatment for early gastric cancer.However,post-endoscopic submucosal dissection(ESD)ulcer occurs in 4.4%of patients.This study hypothesized whether applying PuraStat,a novel hemostatic peptide solution,prevents post-ESD bleeding.AIM To investigate the preventive potential of PuraStat,a hemostatic formulation,against bleeding in post-ESD gastric ulcers.METHODS Between May 2022 and March 2023,101 patients(Group P)underwent ESD for gastric diseases at our hospital and received PuraStat(2 mL)for post-ESD ulcers.We retrospectively compared this group with a control group(Group C)com-prising 297 patients who underwent ESD for gastric diseases at our hospital between April 2017 and March 2021.P values<0.05 on two-sided tests indicated significance.RESULTS Post-ESD bleeding occurred in 6(5.9%)(95%CI:2.8-12.4)and 20(6.7%)(95%CI:4.4-10.2)patients in Groups P and C,respectively,with no significant between-group difference.The relative risk was 1.01(95%CI:0.95-1.07).The lesser curvature or anterior wall was the bleeding site in all 6 patients who experienced postoperative bleeding in Group P.In multivariate analysis,the odds ratios for resection diameter≥50 mm and oral anticoagulant use were 6.63(95%CI:2.52-14.47;P=0.0001)and 4.04(1.26-0.69;P=0.0164),respectively.The adjusted odds ratio of post-ESD bleeding and PuraStat was 1.28(95%CI:0.28-2.15).CONCLUSION PuraStat application is not associated with post-ESD bleeding.However,the study suggests that gravitational forces may affect the effectiveness of applied PuraStat.展开更多
目的:探讨止血囊与纱条填塞分别联合腹主动脉临时阻断术用于伴胎盘植入孕妇剖宫产术中止血的价值。方法:回顾性分析伴胎盘植入且有意愿保留子宫的185例孕妇的临床资料,按照手术止血方法不同分为止血囊组(n=92)和纱条组(n=93)。对比两组...目的:探讨止血囊与纱条填塞分别联合腹主动脉临时阻断术用于伴胎盘植入孕妇剖宫产术中止血的价值。方法:回顾性分析伴胎盘植入且有意愿保留子宫的185例孕妇的临床资料,按照手术止血方法不同分为止血囊组(n=92)和纱条组(n=93)。对比两组手术相关指标(腹主动脉临时阻断时间、止血成功率、填塞物脱落率、填塞时间)、围术期出血量、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT),统计并发症总发生率。结果:止血囊组腹主动脉临时阻断时间和填塞时间短于纱条组(P<0.05),术中及术后2、24 h出血量均少于纱条组(P<0.05),止血成功率高于纱条组(P<0.05),填塞物脱落率和术后并发症总发生率均低于纱条组(P<0.05),术后24 h FIB高于纱条组(P<0.05),PT和APTT低于纱条组(P<0.05)。结论:腹主动脉临时阻断术联合止血囊以及纱条均可有效改善伴胎盘植入剖宫产术中出血,止血囊成功率和安全性更高。展开更多
背景:骨蜡是可用于骨止血的填塞剂,国内外虽一直在修正骨蜡配方,但无法改变其难以被吸收的核心瓶颈,因此开发具有止血、成骨和抗菌等功能化的骨科止血材料替代骨蜡具有迫切的临床需求。目的:回顾包括骨蜡和其替代材料在内的骨科止血材...背景:骨蜡是可用于骨止血的填塞剂,国内外虽一直在修正骨蜡配方,但无法改变其难以被吸收的核心瓶颈,因此开发具有止血、成骨和抗菌等功能化的骨科止血材料替代骨蜡具有迫切的临床需求。目的:回顾包括骨蜡和其替代材料在内的骨科止血材料的发展历程。方法:检索Pub Med、Web of Science、万方数据库、中国知网及维普数据库中与骨蜡、止血材料、骨科止血材料研究进展相关的文献,并通过阅读文章中的摘要部分初筛,选择了136篇文献纳入综述。结果与结论:为替代传统骨蜡,研究人员从止血、成骨等实际场景的需求出发,开发出各式骨科止血材料,但相关研究多集中于基础的理化和性能测试,缺乏系统的评价体系,同时欠缺足够的大动物实验和临床试验报道。因此,目前骨蜡依旧是公认的骨科止血材料,其根本原因是已有材料的设计无法适时满足术中止血、术后成骨及临床上的新需求。未来还需要对现有止血和成骨材料的结构、组分和功能进行整合和再设计,以满足不断提高的止血与成骨需求。展开更多
文摘Hemostatic radiotherapy is a non-invasive treatment for bleeding gastrointestinal(GI)tumors,promoting tumor shrinkage,blood supply reduction,and fibrotic tissue formation.It is effective in cases where traditional interventions are insufficient or contraindicated and can prevent recurrent bleeding in patients with GI bleeding histories.Hypofractionation schedules are also effective for tumor control and patient compliance.
基金This study was reviewed and approved by the Showa University Institutional Review Board(2023-052-A).
文摘BACKGROUND Endoscopic mucosal dissection has become the standard treatment for early gastric cancer.However,post-endoscopic submucosal dissection(ESD)ulcer occurs in 4.4%of patients.This study hypothesized whether applying PuraStat,a novel hemostatic peptide solution,prevents post-ESD bleeding.AIM To investigate the preventive potential of PuraStat,a hemostatic formulation,against bleeding in post-ESD gastric ulcers.METHODS Between May 2022 and March 2023,101 patients(Group P)underwent ESD for gastric diseases at our hospital and received PuraStat(2 mL)for post-ESD ulcers.We retrospectively compared this group with a control group(Group C)com-prising 297 patients who underwent ESD for gastric diseases at our hospital between April 2017 and March 2021.P values<0.05 on two-sided tests indicated significance.RESULTS Post-ESD bleeding occurred in 6(5.9%)(95%CI:2.8-12.4)and 20(6.7%)(95%CI:4.4-10.2)patients in Groups P and C,respectively,with no significant between-group difference.The relative risk was 1.01(95%CI:0.95-1.07).The lesser curvature or anterior wall was the bleeding site in all 6 patients who experienced postoperative bleeding in Group P.In multivariate analysis,the odds ratios for resection diameter≥50 mm and oral anticoagulant use were 6.63(95%CI:2.52-14.47;P=0.0001)and 4.04(1.26-0.69;P=0.0164),respectively.The adjusted odds ratio of post-ESD bleeding and PuraStat was 1.28(95%CI:0.28-2.15).CONCLUSION PuraStat application is not associated with post-ESD bleeding.However,the study suggests that gravitational forces may affect the effectiveness of applied PuraStat.
文摘目的:探讨止血囊与纱条填塞分别联合腹主动脉临时阻断术用于伴胎盘植入孕妇剖宫产术中止血的价值。方法:回顾性分析伴胎盘植入且有意愿保留子宫的185例孕妇的临床资料,按照手术止血方法不同分为止血囊组(n=92)和纱条组(n=93)。对比两组手术相关指标(腹主动脉临时阻断时间、止血成功率、填塞物脱落率、填塞时间)、围术期出血量、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT),统计并发症总发生率。结果:止血囊组腹主动脉临时阻断时间和填塞时间短于纱条组(P<0.05),术中及术后2、24 h出血量均少于纱条组(P<0.05),止血成功率高于纱条组(P<0.05),填塞物脱落率和术后并发症总发生率均低于纱条组(P<0.05),术后24 h FIB高于纱条组(P<0.05),PT和APTT低于纱条组(P<0.05)。结论:腹主动脉临时阻断术联合止血囊以及纱条均可有效改善伴胎盘植入剖宫产术中出血,止血囊成功率和安全性更高。
文摘背景:骨蜡是可用于骨止血的填塞剂,国内外虽一直在修正骨蜡配方,但无法改变其难以被吸收的核心瓶颈,因此开发具有止血、成骨和抗菌等功能化的骨科止血材料替代骨蜡具有迫切的临床需求。目的:回顾包括骨蜡和其替代材料在内的骨科止血材料的发展历程。方法:检索Pub Med、Web of Science、万方数据库、中国知网及维普数据库中与骨蜡、止血材料、骨科止血材料研究进展相关的文献,并通过阅读文章中的摘要部分初筛,选择了136篇文献纳入综述。结果与结论:为替代传统骨蜡,研究人员从止血、成骨等实际场景的需求出发,开发出各式骨科止血材料,但相关研究多集中于基础的理化和性能测试,缺乏系统的评价体系,同时欠缺足够的大动物实验和临床试验报道。因此,目前骨蜡依旧是公认的骨科止血材料,其根本原因是已有材料的设计无法适时满足术中止血、术后成骨及临床上的新需求。未来还需要对现有止血和成骨材料的结构、组分和功能进行整合和再设计,以满足不断提高的止血与成骨需求。
