严重下消化道出血患者ct血管造影阳性后导管血管造影与结肠镜再出血风险的比较分析。

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gut and Liver Pub Date : 2025-08-08 DOI:10.5009/gnl250152
Jihye Park, Seo Yoon Choi, Soo Jung Park, Jae Jun Park, Tae Il Kim, Jae Hee Cheon
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引用次数: 0

摘要

背景/目的:很少有研究比较严重下消化道出血患者在ct血管造影(CTA)阳性结果后进行导管血管造影和结肠镜检查的结果。本研究旨在评估这些方法在临床结果上的差异。方法:我们分析了韩国Severance医院(2014-2024)254例下胃肠道CTA阳性患者的数据。比较导管血管造影组(n=108)和结肠镜检查组(n=146)的临床结果,并检查再出血的预测危险因素。结果:两组确诊率(59.3% vs 47.9%)、治疗率(64.8% vs 56.2%)和平均住院时间(20.1 d vs 21.3 d)无显著差异。然而,导管血管造影组的平均手术时间(12.3小时对19.2小时)和再出血率(36.1%对48.6%)较低。逻辑回归显示,手术时间预示着更高的确诊率和治疗率。多因素Cox回归分析显示,再出血的危险因素包括接受5个单位的填充红细胞(危险比[HR], 1.711;95%可信区间[CI], 1.025 ~ 2.857, p=0.040)和行结肠镜检查代替导管血管造影(HR, 1.922;95% CI, 1.242 ~ 2.974, p=0.003)。结论:在CTA阳性结果后,结肠镜检查(与导管血管造影相比)和需要超过5单位的填充红细胞输血是再出血的重要危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Analysis of the Risk of Rebleeding between Catheter Angiography and Colonoscopy Following a Positive Computed Tomography Angiography Results in Patients with Severe Lower Gastrointestinal Bleeding.

Background/aims: Few studies have compared the outcomes of catheter angiography and colonoscopy after positive computed tomography angiography (CTA) results in patients with severe lower gastrointestinal bleeding. This study aimed to evaluate differences in clinical outcomes between these approaches.

Methods: We analyzed data from 254 patients with positive CTA results of the lower gastrointestinal tract at Severance Hospital, South Korea (2014-2024). Clinical outcomes were compared between the catheter angiography group (n=108) and the colonoscopy group (n=146), and the predictive risk factors for rebleeding were examined.

Results: There were no significant differences in the confirmation yield (59.3% vs 47.9%), therapeutic yield (64.8% vs 56.2%), and mean hospitalization duration (20.1 days vs 21.3 days) between groups. However, the mean time to procedure (12.3 hours vs 19.2 hours) and rebleeding rate (36.1% vs 48.6%) were lower in the catheter angiography group. Logistic regression revealed that time to procedure predicted higher confirmation and therapeutic yields. Multivariate Cox regression showed that risk factors for rebleeding included receiving >5 units of packed red blood cells (hazard ratio [HR], 1.711; 95% confidence interval [CI], 1.025 to 2.857, p=0.040) and undergoing colonoscopy instead of catheter angiography (HR, 1.922; 95% CI, 1.242 to 2.974, p=0.003).

Conclusions: Following a positive CTA result, colonoscopy (compared to catheter angiography) and the need for more than 5 units of packed red blood cell transfusion were significant risk factors for rebleeding.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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