The clinical outcome of upper gastrointestinal bleeding has improved due to advances in endoscopic therapy and standardized peri‐endoscopy care. Apart from validating clinical scores, artificial intelligence‐assisted machine learning models may play an important role in risk stratification. While standard endoscopic treatments remain irreplaceable, novel endoscopic modalities have changed the landscape of management. Over‐the‐scope clips have high success rates as rescue or even first‐line treatments in difficult‐to‐treat cases. Hemostatic powder is safe and easy to use, which can be useful as temporary control with its high immediate hemostatic ability. After endoscopic hemostasis, Doppler endoscopic probe can offer an objective measure to guide the treatment endpoint. In refractory bleeding, angiographic embolization should be considered before salvage surgery. In variceal hemorrhage, banding ligation and glue injection are first‐line treatment options. Endoscopic ultrasound‐guided therapy is gaining popularity due to its capability of precise localization for treatment targets. A self‐expandable metal stent may be considered as an alternative option to balloon tamponade in refractory bleeding. Transjugular intrahepatic portosystemic shunting should be reserved as salvage therapy. In this article, we aim to provide an evidence‐based comprehensive review of the major advancements in endoscopic hemostatic techniques and clinical outcomes.

中文翻译：

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2020 年 UGI 出血的治疗：新技术和成果

由于内窥镜治疗和标准化围内窥镜护理的进步，上消化道出血的临床结果有所改善。除了验证临床评分外，人工智能辅助机器学习模型可能在风险分层中发挥重要作用。虽然标准的内窥镜治疗仍然不可替代，但新的内窥镜方式已经改变了管理的格局。在难治性病例中，超镜夹作为抢救甚至一线治疗的成功率很高。止血粉安全且易于使用，具有很高的即刻止血能力，可用作临时控制。内窥镜止血后，多普勒内窥镜探头可以提供客观的措施来指导治疗终点。在难治性出血中，抢救性手术前应考虑血管造影栓塞术。在静脉曲张出血中，套扎结扎和注射胶水是一线治疗选择。内窥镜超声引导治疗因其精确定位治疗目标的能力而越来越受欢迎。自膨式金属支架可被认为是难治性出血中球囊填塞的替代选择。应保留经颈静脉肝内门体分流术作为挽救治疗。在本文中，我们旨在对内窥镜止血技术和临床结果的主要进步进行循证全面回顾。内窥镜超声引导治疗因其精确定位治疗目标的能力而越来越受欢迎。自膨式金属支架可被认为是难治性出血中球囊填塞的替代选择。应保留经颈静脉肝内门体分流术作为挽救治疗。在本文中，我们旨在对内窥镜止血技术和临床结果的主要进步进行循证全面回顾。内窥镜超声引导治疗因其精确定位治疗目标的能力而越来越受欢迎。自膨式金属支架可被认为是难治性出血中球囊填塞的替代选择。应保留经颈静脉肝内门体分流术作为挽救治疗。在本文中，我们旨在对内窥镜止血技术和临床结果的主要进步进行循证全面回顾。