The efficacy of Hemospray in patients with upper gastrointestinal bleeding from tumor.
The efficacy of Hemospray in patients with upper gastrointestinal bleeding from tumor.
复制标题
DOI：
10.1055/s-0042-109863
复制
发表时间：
2016-09
影响因子：
2.6
通讯作者：
Rerknimitr R
中科院分区：
文献类型：
--
作者：
Pittayanon R;Prueksapanich P;Rerknimitr R
背景与研究目的：目前，常规内镜治疗上消化道肿瘤出血的止血效果不理想。血液喷雾已被证明是有用的，在许多活跃的胃肠道出血条件。本研究旨在比较止血喷雾与常规内镜止血的疗效。患者与方法：选取肿瘤性上消化道活动性出血患者14例。在出血部位使用止血喷雾，直至止血成功。4例患者被排除，因为他们过早接受了明确的治疗，以防止48小时内进一步出血。另外10名既往对照组患者根据胃肠道肿瘤类型进行匹配。观察14天再出血率、住院时间（LOS）和随访30天死亡率。结果：基线特征包括年龄、肿瘤分期和布拉奇福德评分在两组之间没有差异。止血喷雾组14天再出血率比对照组低3倍，但无统计学意义（10%比30%；P = 0.60）。两组间LOS差异无统计学意义（28.2±21.2 vs. 23.8±12.5 d; P = 0.26）。止血喷雾组30天死亡率比常规治疗组低3倍，但差异无统计学意义（10% vs 30%, P = 0.7）。结论：止血喷雾是一种很有前景的治疗上消化道肿瘤出血的初始止血方法，因为它可以在最初14天内实现止血，因此在考虑适当的最终干预之前可能有足够的时间。
Background and study aims: Currently, conventional endoscopic treatments provide an unsatisfactory hemostatic outcome in upper gastrointestinal bleeding from tumor. Hemospray has been shown to be useful in many active gastrointestinal bleeding conditions. This study aimed to compare the efficacy of Hemospray and conventional endoscopic hemostasis. Patients and methods: Fourteen patients with active upper gastrointestinal bleeding from tumor were recruited. Hemospray was applied at the bleeding site until hemostasis was achieved. Four patients were excluded because they prematurely received definitive therapy to prevent further bleeding within 48 hours. Another 10 patients from historical control were matched based on the type of gastrointestinal tumors. The 14-day rebleeding rates, length of hospital stay (LOS) and mortality rate at 30-day follow up were assessed. Results: Baseline characteristics including age, stage of tumor, and Blatchford score did not differ between the two groups. The 14-day rebleeding rate in the Hemospray group was 3 times lower than the control group but not statistically significant (10 % vs. 30 %; P = 0.60). LOS was no different between the 2 groups (28.2 ± 21.2 vs. 23.8 ± 12.5 days; P = 0.26). The 30-day mortality rate in the Hemospray group was 3 times lower than that of in the conventional therapy group but not significant (10 % vs. 30 %, P = 0.7). Conclusions: Hemospray is a promising therapy for initial hemostasis in upper gastrointestinal bleeding from tumor because it can achieve hemostasis during the first 14 days, thus potentially allowing sufficient time before appropriate definitive intervention is considered.