当前位置: X-MOL 学术Gastrointest. Endosc. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Successful hemostasis of active lower GI bleeding using a hemostatic powder as monotherapy, combination therapy, or rescue therapy
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2018-10-26 , DOI: 10.1016/j.gie.2018.10.029
Lawrence Hookey , Alan Barkun , Richard Sultanian , Robert Bailey

Background and Aims

Acute lower GI bleeding is a frequent cause of hospital admission. The objective of this study was to evaluate the safety and performance of a hemostatic powder (TC-325/Hemospray) in the treatment of nonvariceal lower GI bleeding.

Methods

Patients were enrolled into this prospective, multicenter, single-arm study at 4 tertiary care centers in Canada. Fifty patients with active lower GI bleeding of multiple different causes (52 bleeding sites) underwent topical endoscopic application of hemostatic powder. The primary endpoint was powder-related adverse events within 30 days of the index procedure. Secondary endpoints were initial hemostasis as well as recurrent bleeding and mortality within 30 days of the index procedure.

Results

Most patients (96%) had a single bleeding site, and most bleeding (73%) was due to polypectomy. Overall, the powder was applied as monotherapy in 13 bleeding sites (25%), as combination therapy in 22 bleeding sites (42.3%), and as rescue therapy in 17 bleeding sites (32.7%). Hemostasis was achieved in 98% of patients. No patient experienced a powder-related adverse event. Five patients (10%) developed recurrent bleeding within 30 days. One patient (2%) died within 30 days of powder application, but the death was not directly related to hemostatic powder use.

Conclusions

The hemostatic powder is a safe and effective option for patients with lower GI bleeding of varying causes, and in particular, postpolypectomy hemorrhage. The hemostatic powder is effective as monotherapy, part of a combination approach, or as a rescue therapeutic option for the treatment of nonvariceal lower GI bleeding. (Clinical trial registration number: NCT02099435.)



中文翻译:

使用止血粉作为单一疗法,联合疗法或抢救疗法可成功止血主动下消化道出血

背景和目标

急性下消化道出血是住院的常见原因。这项研究的目的是评估止血粉(TC-325 / Hemospray)在治疗非静脉曲张性下消化道出血中的安全性和性能。

方法

在加拿大的4个三级医疗中心,患者参加了这项前瞻性,多中心,单臂研究。五十例因多种原因引起的主动下消化道出血的患者(52个出血部位)接受了内镜止血粉的局部应用。主要终点指标是指法后30天内与粉剂相关的不良事件。次要终点是指标手术后30天内的最初止血以及复发性出血和死亡率。

结果

大多数患者(96%)只有一个出血点,而大多数出血(73%)是由于息肉切除术造成的。总体而言,该粉末在13个出血部位(25%)作为单一疗法,在22个出血部位(42.3%)作为联合疗法,在17个出血部位(32.7%)作为抢救疗法。98%的患者实现了止血。没有患者经历过粉末相关的不良事件。5例患者(10%)在30天内出现了复发性出血。一名患者(2%)在使用粉剂后30天内死亡,但死亡与止血粉的使用没有直接关系。

结论

对于各种原因引起的较低胃肠道出血的患者,尤其是息肉切除术后出血,止血粉是一种安全有效的选择。止血粉可作为单一疗法,组合疗法的一部分有效,或作为非静脉曲张性下消化道出血的抢救性治疗选择。(临床试验注册号:NCT02099435。)

更新日期:2018-10-26
down
wechat
bug