期刊文献+
共找到63篇文章
< 1 2 4 >
每页显示 20 50 100
Diagnosis and therapeutic strategies for small bowel vascular lesions 预览
1
作者 Eiji Sakai Ken Ohata +1 位作者 Atsushi Nakajima Nobuyuki Matsuhashi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第22期2720-2733,共14页
Small bowel vascular lesions, including angioectasia (AE), Dieulafoy’s lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be ... Small bowel vascular lesions, including angioectasia (AE), Dieulafoy’s lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be venous lesions, they usually manifest as a chronic, well-compensated condition. Subsequent to video capsule endoscopy, deep enteroscopy can be applied to control active bleeding or to improve anemia necessitating blood transfusion. Despite the initial treatment efficacy of argon plasma coagulation (APC), many patients experience re-bleeding, probably because of recurrent or missed AEs. Pharmacological treatments can be considered for patients who have not responded well to other types of treatment or in whom endoscopy is contraindicated. Meanwhile, a conservative approach with iron supplementation remains an option for patients with mild anemia. DL and AVM are considered to be arterial lesions;therefore, these lesions frequently cause acute life-threatening hemorrhage. Mechanical hemostasis using endoclips is recommended to treat DLs, considering the high re-bleeding rate after primary APC cauterization. Meanwhile, most small bowel AVMs are large and susceptible to re-bleeding therefore, they usually require surgical resection. To achieve optimal diagnostic and therapeutic approaches for each type of small bowel lesion, the differences in their epidemiology, pathology and clinical presentation must be understood. 展开更多
关键词 ANGIODYSPLASIA Angioectasia Dieulafoy's lesion ARTERIOVENOUS MALFORMATION Obscure gastrointestinal bleeding Video capsule endoscopy Deep ENTEROSCOPY Argon plasm coagulation
在线阅读 免费下载
转化生长因子β1受体在血管壁稳态及主动脉疾病中的研究进展 预览
2
作者 洪俊谋 王志维 《中国临床保健杂志》 CAS 2019年第3期426-429,共4页
主动脉壁的稳态失衡及高血压是主动脉瘤和主动脉夹层等主动脉疾病发生的主要原因。转化生长因子β1受体(TGFβ1)通路在血管发育、血管壁稳态维持、高血压发生中均有重要作用。其中I型受体活化生长因子1(ALK1)及其辅助受体内皮糖蛋白(End... 主动脉壁的稳态失衡及高血压是主动脉瘤和主动脉夹层等主动脉疾病发生的主要原因。转化生长因子β1受体(TGFβ1)通路在血管发育、血管壁稳态维持、高血压发生中均有重要作用。其中I型受体活化生长因子1(ALK1)及其辅助受体内皮糖蛋白(Endoglin)突变是血管动静脉畸形的主要遗传易感原因。因此,本文就TGFβ1及其下游ALK1和Endoglin在主动脉疾病中的研究进展及其可能机制进行综述。 展开更多
关键词 主动脉疾病 受体 转化生长因子β 疾病遗传易感性 血管发育不良 血管畸形 综述
在线阅读 下载PDF
左室流出道梗阻合并消化道出血的研究进展 预览
3
作者 于琛 赵彧墨 吴东 《基础医学与临床》 CSCD 2018年第11期1644-1648,共5页
肥厚型心肌病(HCM)及主动脉瓣狭窄(AS)是左室流出道(LVOT)梗阻的常见病因。由于左室流出道梗阻的血流动力学改变,血流中高剪切力破坏血管性血友病因子高分子量多聚体,可引起获得性血管性血友病(AvWS),继而在伴/不伴消化道血管发育不良... 肥厚型心肌病(HCM)及主动脉瓣狭窄(AS)是左室流出道(LVOT)梗阻的常见病因。由于左室流出道梗阻的血流动力学改变,血流中高剪切力破坏血管性血友病因子高分子量多聚体,可引起获得性血管性血友病(AvWS),继而在伴/不伴消化道血管发育不良的情况下,增加消化道出血风险。针对AS或HCM的治疗如主动脉瓣置换术、室间隔部分切除术或化学消融术可显著降低消化道出血的再发风险。目前对于左室流出道梗阻合并消化道出血在流行病学、发病机制、临床表现及诊治等方面的了解尚不够深入。 展开更多
关键词 肥厚型心肌病 血管发育不良 消化道出血 获得性血管性血友病
在线阅读 下载PDF
椎动脉发育不良对老年后循环小梗死患者早期磁共振成像假阴性率的影响
4
作者 张道培 任雅芳 +3 位作者 张怀亮 禹萌 张淑玲 尹所 《中华老年医学杂志》 CSCD 北大核心 2018年第8期864-869,共6页
目的 探讨椎动脉发育不良(VAH)对表现为急性孤立性前庭综合征的老年后循环小梗死(头颅MRI-DWI轴位梗死直径≤10 mm)患者早期磁共振成像(MRI)假阴性率的影响. 方法 连续入选224例老年高危急性孤立性前庭综合征(合并≥1个血管危险... 目的 探讨椎动脉发育不良(VAH)对表现为急性孤立性前庭综合征的老年后循环小梗死(头颅MRI-DWI轴位梗死直径≤10 mm)患者早期磁共振成像(MRI)假阴性率的影响. 方法 连续入选224例老年高危急性孤立性前庭综合征(合并≥1个血管危险因素)患者进行前瞻性观察.尽可能在头颅MRI-DWI完成前进行头脉冲、凝视诱发眼震、眼偏斜(HINTS)+脑干听觉诱发电位(BAEP)+瞬目反射(BR)检查,对早期DWI正常而HINTS+ BAEP十BR检查策略怀疑中枢损害的患者72 h后复查DWI.把患者分为VAH组和非VAH组. 结果 98例患者发生后循环梗死,其中小梗死37例,VAH组16例(16/61,26.2%),非VAH组21例(21/163,12.9%),差异有统计学意义(x2 =4.58,P<0.05).头颅MRI-DWI假阴性患者,VAH组9例(9/16,56.3%),非VAH组4例(4/21,19.0%),差异有统计学意义(x2=6.23,P<o.001).HINTS+ BAEP+ BR对筛查小梗死的敏感性与早期头颅MRI-DWI比较,VAH组(100.0%比44.0%,U=6.41,P<0.001),非VAH组(100.0%比81.0%,U=4.46,P<0.05).VAH组BAEP的Ⅴ波峰潜伏期、Ⅲ~Ⅴ、Ⅰ~Ⅴ波间潜伏期以及BR的R1及R2、R2'潜伏期均较非VAH组延长,差异有统计学意义(均P<0.05). 结论 老年高危急性孤立性前庭综合征患者,存在VAH时合并小梗死发生率高,MRI-DWI早期假阴性发生率高,HINTS+ BAEP+ BR检查策略有助于提高诊断敏感性. 展开更多
关键词 椎动脉 血管发育不良 脑梗死 前庭综合征 磁共振成像
Assessment of serum angiogenic factors as a diagnostic aid for small bowel angiodysplasia in patients with obscure gastrointestinal bleeding and anaemia 预览
5
作者 Grainne Holleran Mary Hussey +1 位作者 Sinead Smith Deirdre McNamara 《世界胃肠病理生理学杂志:英文版(电子版)》 2017年第3期127-132,共6页
AIM To assess the use of serum levels of angiopoietin-1(Ang1), Ang2 and tumor necrosis factor-α(TNFα) as predictive factors for small bowel angiodysplasia(SBA).METHODS Serum samples were collected from patients unde... AIM To assess the use of serum levels of angiopoietin-1(Ang1), Ang2 and tumor necrosis factor-α(TNFα) as predictive factors for small bowel angiodysplasia(SBA).METHODS Serum samples were collected from patients undergoing capsule endoscopy for any cause of obscure gastrointestinal bleeding(OGIB) or anaemia. Based on small bowel findings patients were divided into 3 groups:(1) SBA;(2) other bleeding causes; and(3) normal, according to diagnosis. Using ELISA technique we measured serum levels of Ang1, Ang2 and TNFα and compared mean and median levels between the groups based on small bowel diagnosis. Using receiver operator curve analysis we determined whether any of the factors were predictive of SBA.RESULTS Serum samples were collected from a total of 120 patients undergoing capsule endoscopy for OGIB or anaemia: 40 with SBA, 40 with other causes of small bowel bleeding, and 40 with normal small bowel findings. Mean and median serum levels were measured and compared between groups; patients with SBA had significantly higher median serum levels of Ang2(3759 pg/mL) compared to both other groups, with no significant differences in levels of Ang1 or TNFα based on diagnosis. There were no differences in Ang2 levels between the other bleeding causes(2261 pg/mL) and normal(2620pg/mL) groups. Using Receiver Operator Curve analysis, an Ang2 level of > 2600 pg/mL was found to be predictive of SBA, with an area under the curve of 0.7. Neither Ang1 or TNFα were useful as predictive markers.CONCLUSION Elevations in serum Ang2 are specific for SBA and not driven by other causes of bleeding and anaemia. Further work will determine whether Ang2 is useful as a diagnostic or prognostic marker for SBA. 展开更多
关键词 ANGIODYSPLASIA 小肠的流血 囊内视镜检查法 Angiogenic 因素 ANGIOPOIETIN-2
在线阅读 免费下载
Gastrointestinal bleeding in a patient with a continuous-flow biventricular assist device 预览
6
作者 Raymond V Mirasol Jason J Tholany +4 位作者 Hasini Reddy Billie S Fyfe-Kirschner Christina L Cheng Issam F Moubarak John L Nosher 《世界放射学杂志:英文版(电子版)》 2016年第4期428-433,共6页
The association between continuous-flow left ventricular assist devices(CF-LVADs)and gastrointestinal(GI)bleeding from angiodysplasia is well recognized.However,the association between continuous-flow biventricular as... The association between continuous-flow left ventricular assist devices(CF-LVADs)and gastrointestinal(GI)bleeding from angiodysplasia is well recognized.However,the association between continuous-flow biventricular assist devices(CF-BIVADs)and bleeding angiodysplasia is less understood.We report a case of GI bleeding from a patient with a CF-BIVAD.The location of GI bleeding was identified by nuclear red blood cell bleeding scan.The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology.The intensity of bleeding,reflected by number of units of packed red blood cells needed for normalization of hemoglobin,as well as the time to onset of bleeding after transplantation,are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs.While angiography only detected a dilated late draining vein,pathology demonstrated the presence of both arterial and venous dilation in the submucosa,vascular abnormalities characteristic of a late arteriovenous malformation. 展开更多
关键词 CONTINUOUS-FLOW VENTRICULAR assist devices ANGIODYSPLASIA GASTROINTESTINAL BLEEDING ANGIOGRAPHY Heart failure
在线阅读 免费下载
Effective treatment of gastrointestinal bleeding with thalidomide- Chances and limitations 预览
7
作者 Juergen Bauditz 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第11期3158-3164,共7页
For more than 50 years bleeding from gastrointestinal angiodysplasias has been treated by hormonal therapy with estrogens and progesterons. After a randomized study finally demonstrated that hormones have no effect on... For more than 50 years bleeding from gastrointestinal angiodysplasias has been treated by hormonal therapy with estrogens and progesterons. After a randomized study finally demonstrated that hormones have no effect on bleeding events and transfusion requirements, therapy has switched to endoscopic coagulation. However, angiodysplasias tend to recur over months to years and endoscopy often has to be repeated for long time periods. Thalidomide, which caused severe deformities in newborn children in the 1960 s, is now increasingly used after it was shown to suppress tumor necrosis factor alpha, inhibi t angiogenesis and to be also effective for treatment of multiple myeloma. In 2011 thalidomide was proven to be highly effective for treatment of bleeding from gastrointestinal angiodysplasias in a randomized study. Further evidence by uncontrolled studies exists that thalidomide is also useful for treatment of bleeding in hereditary hemorrhagic telangiectasia. In spite of this data, endoscopic therapy remains the treatment of choice in many hospitals, as thalidomide is still notorious for its teratogenicity. However, patients with gastrointestinal bleeding related to angiodysplasias are generally at an age in which women have no child-bearing potential. Teratogenicity is therefore no issue for these elderly patients. Other side-effects of thalidomide like neurotoxicity may limit treatment options but can be monitored safely. 展开更多
关键词 THALIDOMIDE ANGIODYSPLASIA Vascular MALFORMATION Gastrointestine BLEEDING Therapy ANGIOGENESIS Vascu
在线阅读 免费下载
先天性颈内动脉缺如患者的影像学诊断 被引量:2
8
作者 张鹏 郑雪平 +4 位作者 付伟伟 刘学军 冯卫华 陈海松 徐文坚 《中华神经科杂志》 CAS CSCD 北大核心 2016年第2期108-112,共5页
目的探讨先天性颈内动脉缺如的就诊原因与影像学特点。方法报道4例先天性颈内动脉缺如患者并对以往相关文献总结分析。结果4例患者发病年龄35~53岁,中位发病年龄43.5岁。其中男性1例,女性3例,就诊原因分别为蛛网膜下腔出血(SAH)... 目的探讨先天性颈内动脉缺如的就诊原因与影像学特点。方法报道4例先天性颈内动脉缺如患者并对以往相关文献总结分析。结果4例患者发病年龄35~53岁,中位发病年龄43.5岁。其中男性1例,女性3例,就诊原因分别为蛛网膜下腔出血(SAH)1例,短暂性脑缺血发作(TIA)1例,痫性发作1例,头晕并头痛1例。4例患者颈动脉血管造影均示单侧或双侧颈动脉未显影,颈内动脉管缺如并颅内血管发育异常,其中伴基底动脉及后交通动脉迂曲扩张者3例,伴动脉瘤者2例。结论先天性颈内动脉缺如在各年龄段均可发病,儿童及青少年以SAH为首发症状多见,中老年人以TIA起病多见。影像学表现为:(1)CT骨算法示颈内动脉管缺如;(2)CT血管造影(CTA)或磁共振脑血管造影示颈内动脉全程不显影;(3)合并多种血管发育异常,如异常分支、代偿性迂曲扩张、动静脉畸形、动脉瘤等。颈动脉CTA是诊断先天性颈动脉缺如的首选影像学手段。 展开更多
关键词 颈内动脉 血管发育不良 蛛网膜下腔出血 脑缺血发作 短暂性 血管造影术
中消化道出血患者小肠胶囊内镜的诊断和随访研究 预览 被引量:1
9
作者 张爽 王莉 +3 位作者 张旭 叶云 胡欣 张朋悦 《胃肠病学》 2016年第4期241-243,共3页
背景:小肠胶囊内镜(SBCE)已成为小肠疾病的一线检查技术。目的:评估SBCE对中消化道出血(MGIB)患者的诊断能力和诊断价值。方法:选取2012年1月—2014年12月安徽省蚌埠市第三人民医院MGIB患者,行SBCE检查,分析SBCE对MGIB患者的诊断能力和... 背景:小肠胶囊内镜(SBCE)已成为小肠疾病的一线检查技术。目的:评估SBCE对中消化道出血(MGIB)患者的诊断能力和诊断价值。方法:选取2012年1月—2014年12月安徽省蚌埠市第三人民医院MGIB患者,行SBCE检查,分析SBCE对MGIB患者的诊断能力和诊断价值。通过门诊和电话随访患者发生消化道再出血的情况。结果:连续纳入44例MGIB患者行SBCE检查,病变检出率为95.5%,阳性率为65.9%。SBCE阳性组中前3位病因依次为血管发育异常(37.9%)、炎症改变(31.0%)和肿瘤(20.7%)。随访结果显示SBCE阳性组和非阳性组再出血发生率相比差异有统计学意义(41.4%对13.3%,P<0.05)。结论:血管发育异常仍是MGIB的最主要病因,同时炎症改变和肿瘤所占比例呈上升趋势。SBCE在MGIB患者初筛中有较高的检出率和阳性率,阴性结果预测发生消化道再出血的风险低。 展开更多
关键词 胃肠出血 小肠胶囊内镜 血管发育异常 诊断 随访研究
在线阅读 下载PDF
Re-bleeding events in patients with obscure gastrointestinalbleeding after negative capsule endoscopy 预览
10
作者 Pedro Magalh?es-Costa Miguel Bispo Sofia Santos Gilberto Couto Leopoldo Matos Cristina Chagas 《世界胃肠内镜杂志:英文版(电子版)》 2015年第4期403-410,共8页
a negative capsule endoscopy in patients with obscuregastrointestinal bleeding (OGIB) and the risk factorsassociated with the procedure.METHODS: Patients referred to Hospital Egas Moniz(Lisboa, Portugal) between ... a negative capsule endoscopy in patients with obscuregastrointestinal bleeding (OGIB) and the risk factorsassociated with the procedure.METHODS: Patients referred to Hospital Egas Moniz(Lisboa, Portugal) between January 2006 and October2012 with OGIB and a negative capsule endoscopy wereretrospectively analyzed. The following study variableswere included: demographic data, comorbidities,bleeding-related drug use, hemoglobin level, indicationfor capsule endoscopy, post procedure details, work-upand follow-up. Re-bleeding rates and associated factorswere assessed using a Cox proportional hazard analysis.The Kaplan-Meier method was used to estimate thecumulative incidence of re-bleeding at 1, 3 and 5 years,and the differences between factors were evaluated.RESULTS: The study population consisted of 640patients referred for OGIB investigation. Wirelesscapsule endoscopy was deemed negative in 113patients (17.7%). A total of 64.6% of the populationwas female, and the median age was 69 years. Themedian follow-up was forty-eight months (interquartilerange 24-60). Re-bleeding occurred in 27.4% of thecases. The median time to re-bleeding was fifteenmonths (interquartile range 2-33). In 22.6% (n = 7)of the population, small-bowel angiodysplasia wasidentified as the culprit lesion. A univariate analysisshowed that age 〉 65 years old, chronic kidney disease,aortic stenosis, anticoagulant use and overt OGIB wererisk factors for re-bleeding; however, on a multivariateanalysis, there were no risk factors for re-bleeding. Thecumulative risk of re-bleeding at 1, 3 and 5 years offollow-up was 12.9%, 25.6% and 31.5%, respectively. Magalh‘s-Costa P et al . A long-term follow-up study for re-bleeding events Patients who presented with overt OGIB tended to rebleed sooner (median time for re-bleeding: 8.5 mo vs 22 mo). CONCLUSION: Patients with OGIB despite a negative capsule endoscopy have a significant re-bleeding risk; therefore, these patients require an extended follow-up strategy. 展开更多
关键词 CAPSULE ENDOSCOPY Gastrointestinalhemorrhage ANEMIA ANGIODYSPLASIA Risk factors
在线阅读 免费下载
沙利度胺治疗小肠血管发育不良所致消化道出血的疗效观察 预览 被引量:3
11
作者 邓家征 申洋 邓宏 《成都医学院学报》 CAS 2015年第1期76-79,共4页
目的 观察沙利度胺治疗小肠血管发育不良所致消化道出血的临床疗效。方法 收集2010年1月至2013年10月德阳市人民医院消化内科小肠血管发育不良所致消化道出血患者24例,给予沙利度胺100 mg/d口服,疗程4个月,随访12个月,观察治疗前、... 目的 观察沙利度胺治疗小肠血管发育不良所致消化道出血的临床疗效。方法 收集2010年1月至2013年10月德阳市人民医院消化内科小肠血管发育不良所致消化道出血患者24例,给予沙利度胺100 mg/d口服,疗程4个月,随访12个月,观察治疗前、后患者临床疗效和血清血管内皮生长因子(VEGF)浓度变化。结果 患者临床疗效总评分由治疗前(14.40±3.25)分降至治疗后(5.26±3.18)分;患者血清VEGF浓度治疗前(182±30.8)pg/mL,治疗后(112±26.7)pg/mL,两组比较差异有统计学意义(P〈0.01)。结论 沙利度胺对小肠血管发育不良所致的消化道出血疗效显著,可有效抑制患者的血清VEGF水平,值得临床推广应用。 展开更多
关键词 消化道出血 沙利度胺 血管发育不良 治疗
在线阅读 下载PDF
New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics 预览
12
作者 Antonio Damián Sánchez-Capilla Paloma De La Torre-Rubio Eduardo Redondo-Cerezo 《世界胃肠病理生理学杂志:英文版(电子版)》 2014年第3期271-283,共13页
Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better ... Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem. 展开更多
关键词 Obscure gastrointestinal bleeding ANGIODYSPLASIA Wireless capsule endoscopy Double BALLOON ENTEROSCOPY
在线阅读 免费下载
沙利度胺治疗血管发育不良所致消化道出血的临床观察 预览
13
作者 洪日明 《中国当代医药》 2014年第32期80-81,84共3页
目的:探讨沙利度胺治疗血管发育不良所致消化道出血的临床效果。方法选取2011年2月~2013年11月本院收治的血管发育不良所致消化道出血患者48例,均采用沙利度胺进行治疗,比较治疗前后患者的头晕乏力症状及程度、头晕乏力症状持续时... 目的:探讨沙利度胺治疗血管发育不良所致消化道出血的临床效果。方法选取2011年2月~2013年11月本院收治的血管发育不良所致消化道出血患者48例,均采用沙利度胺进行治疗,比较治疗前后患者的头晕乏力症状及程度、头晕乏力症状持续时间、出血持续时间评分,患者的输血量、血红蛋白水平、出血次数及不良反应发生情况。结果治疗后患者头晕乏力症状程度、头晕乏力症状持续时间及出血持续时间等评分均显著低于治疗前(P<0.05),出血次数及输血量显著少于治疗前(P<0.05),血红蛋白水平显著高于治疗前(P<0.05);48例患者不良反应发生率为10.4%。结论沙利度胺治疗血管发育不良所致消化道出血临床效果显著,不良反应发生率较低,值得临床推广。 展开更多
关键词 血管发育不良 消化道出血 沙利度胺 临床效果
在线阅读 下载PDF
椎动脉起源异常的超声诊断与临床应用 预览 被引量:8
14
作者 杨丽娟 张京芬 《中华老年心脑血管病杂志》 CAS 北大核心 2014年第3期295-297,共3页
目的 探讨彩色多普勒超声在椎动脉起源异常中的诊断价值.方法 回顾性分析彩色多普勒超声检测的3393例患者诊断椎动脉起源异常情况.结果 3393例患者中,椎动脉起源异常123例,左侧122例,右侧1例,总发生率3.63%.椎动脉起源主动脉弓为123例... 目的 探讨彩色多普勒超声在椎动脉起源异常中的诊断价值.方法 回顾性分析彩色多普勒超声检测的3393例患者诊断椎动脉起源异常情况.结果 3393例患者中,椎动脉起源异常123例,左侧122例,右侧1例,总发生率3.63%.椎动脉起源主动脉弓为123例,包括单独起源异常3例,起源异常合并走行变异77例,起源异常合并走行变异、发育不良43例,且合并走行变异.结论 彩色多普勒超声是无创性诊断椎动脉起源异常、发育不良等变异的优良方法. 展开更多
关键词 椎动脉 超声检查 多普勒 彩色 血管发育不良
在线阅读 下载PDF
在有阴暗胃肠的流血的泰国病人的囊内视镜检查法的产量,病原学和结果 预览 被引量:1
15
作者 Supot Pongprasobchai Songla Chitsaeng +2 位作者 Tawesak Tanwandee Sathaporn Manatsathit Udom Kachintorn 《世界胃肠内镜杂志:英文版(电子版)》 2013年第3期122-127,共6页
AIM:To investigate the yield,etiologies and impact of capsule endoscopy(CE) in Thai patients with obscure gastrointestinal bleeding(OGIB).METHODS:The present study is a retrospective cohort study.All patients with OG... AIM:To investigate the yield,etiologies and impact of capsule endoscopy(CE) in Thai patients with obscure gastrointestinal bleeding(OGIB).METHODS:The present study is a retrospective cohort study.All patients with OGIB who underwent CE in Siriraj Hospital,Bangkok,Thailand during 2005-2009 were included in the study.All the patients’ medical records and results of the CE videos were reviewed.CE findings were classified as significant,suspicious/equivocal and negative.Sites of the lesions were located to duodenum,jejunum,jejunoileum,ileum and diffuse lesions by the localization device of the CE.Impact of CE on the patients’ management was defined by any investigation or treatment given to the patients that was more than an iron supplement or blood transfusion.Patients’ outcomes(rebleeding,persistent bleeding,anemia or requirement of blood transfusion) were collected from chart reviews and direct phone interviews with the patients.RESULTS:Overall,there were 103 patients with OGIB included in the study.Mean age of the patients was 64 ± 16 years(range 9-88 years) and 57 patients(55%) were male.Types of OGIB were overt in 80(78%) and occult in 23 patients(22%).The median time interval of CE after onset of OGIB was 10 d(range 1-180 d).The median time of follow-up was 19 mo(range 1-54 mo).Capsules reached caecum in 77 patients(74%) and capsule retention was found in 1 patient(1%).The diagnostic yield of CE revealed significant lesions in 37 patients(36%),suspicious/equivocal lesions in 15 patients(15%) and 51 patients(49%) had negative CE result.Among the significant lesions,the bleeding etiologies were small bowel ulcers in 44%,angiodysplasia in 27%,small bowel tumor in 13%,miscellaneous in 8% and active bleeding without identifiable causes in 8%.Patients with small bowel ulcers were significantly associated with the use of non-steroidal anti-inflammatory drugs(48%,P = 0.034),while patients with small bowel tumors were more commonly female(86%,P = 0.043) compared to the other etiologies.The rate of rebleeding,pe 展开更多
关键词 ANGIODYSPLASIA ETIOLOGY Gastrointestinal BLEEDING Obscure Capsule Endoscopy Outcome Small bowel ULCER Wireless
在线阅读 免费下载
Comparison of double balloon enteroscopy in adults and children 预览 被引量:2
16
作者 Odul Egritas Gurkan Tarkan Karakan +2 位作者 Ibrahim Dogan Buket Dalgic Selahattin Unal 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2013年第29期4726-4731,共6页
AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey b... AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative en-ema. The patients were followed up for 2 h after the procedure in terms of possible complications. RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); PeutzJeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation. CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children. 展开更多
关键词 Double-balloon ENTEROSCOPY Small BOWEL disease POLYP ANGIODYSPLASIA PEUTZ-JEGHERS syndrome
在线阅读 免费下载
在在囊内视镜检查法以后的阴暗胃肠的流血的结果 预览 被引量:2
17
作者 Alex Caas-Ventura Lucia Márque +9 位作者 Xavier Bessa Josep Maria DedeuDepartment of Gastroenterology,Hospital del Mar Research Institute,Pompeu Fabra University Marc Puigvehí Sílvia Delgado-Aros Ines Ana Ibáez Agustin Seoane Luis Barranco Felipe Bory Montserrat Andreu Begoa González-Suárez 《世界胃肠内镜杂志:英文版(电子版)》 2013年第11期551-558,共8页
AIM: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. METHODS: Patie... AIM: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. METHODS: Patients who were referred to Hospital del Mar(Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid antiinflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings(significant or non-significant), work-up and patient out-comes were analyzed from electronic charts. Variables were compared by χ 2 analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-Meier curves and Cox regression model. RESULTS: There were 105 patients [45.7% women, median age of 72 years old(interquartile range 56-79)] and a median follow-up of 326 d(interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1%(55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients(69.5%), OGIB was resolved. Multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios(HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above(HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE(HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding. CONCLUSION: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels 【 8 g/dL, age ≥ 70 years or the presence of significant lesions. 展开更多
关键词 CAPSULE endoscopy Obscure gastrointestinal BLEEDING Small bowel ANGIODYSPLASIA ENTEROSCOPY
在线阅读 免费下载
沙利度胺治疗血管发育不良所致消化道出血的临床疗效及其机制研究 预览 被引量:1
18
作者 付仁清 《中国医学创新》 2013年第32期53-54,共2页
目的:研究分析沙利度胺治疗血管发育不良所致消化道出血的临床疗效及其机制。方法:选取本院2011年10月-2012年11月收治的20例血管发育不良所致消化道出血患者的临床资料进行研究分析。结果:患者实施治疗前总评分为(15.01±5.63... 目的:研究分析沙利度胺治疗血管发育不良所致消化道出血的临床疗效及其机制。方法:选取本院2011年10月-2012年11月收治的20例血管发育不良所致消化道出血患者的临床资料进行研究分析。结果:患者实施治疗前总评分为(15.01±5.63)分,治疗后总评分为(5.33±4.66)分,治疗前后总评分比较差异有统计学意义(P〈0.05)。结论:沙利度胺对于血管发育不良所致消化道出血疾病具有较好疗效,可有效抑制患者的肿瘤坏死因子-α以及血清血管内皮生长因子,值得推广应用。 展开更多
关键词 沙利度胺 血管发育不良 消化道出血 临床疗效
在线阅读 下载PDF
沙利度胺治疗小肠血管发育不良所致消化道出血的疗效观察 预览 被引量:4
19
作者 罗政仁 《现代消化及介入诊疗》 2013年第5期291-293,共3页
目的观察沙利度胺治疗小肠血管发育不良所致消化道出血的临床疗效。方法收集2009年1月.2011年10月小肠血管发育不良所致消化道出血患者20例,给予沙利度胺片100mg/d口服,疗程4个月,观察治疗前、后患者临床疗效。结果患者临床疗效总... 目的观察沙利度胺治疗小肠血管发育不良所致消化道出血的临床疗效。方法收集2009年1月.2011年10月小肠血管发育不良所致消化道出血患者20例,给予沙利度胺片100mg/d口服,疗程4个月,观察治疗前、后患者临床疗效。结果患者临床疗效总评分由治疗前的(14.56±3.30)分降至治疗后的(5.23±3.25)分,差异有统计学意义(P〈0.01)。随访期间,20例患者平均出血次数为(1.00±1.13)次,输血量为(100.00±230.01)mL,均比治疗前显著减少[(11.12±5.73)次和(1338.22±1451.32)mL,P值均〈0.01);治疗后血红蛋白含量为(9.41±2.17)g/mL,比治疗前的(5.68±1.60]g/mL)显著上升(P〈O.01]。结论沙利度胺对小肠血管发育不良所致的消化道出血疗效显著,可望成为一种治疗小肠血管发育不良的有效药物。 展开更多
关键词 消化道出血 沙利度胺 小肠 血管发育不良 治疗
在线阅读 下载PDF
胎儿超声三血管气管观诊断胎儿心脏大血管异常的价值 被引量:7
20
作者 吕慧玲 于进 +3 位作者 吴晓峰 王雪梅 纪向虹 康维强 《中华超声影像学杂志》 CSCD 北大核心 2012年第8期653-656,共4页
目的探讨胎儿三血管气管观对胎儿心脏大血管发育异常的诊断价值。方法分析产前筛查为胎儿大血管异常的孕妇39例,评价分析其三血管气管观的图像特征及意义。结果经尸检证实的39例大血管发育异常中,永存动脉干(7例)、大动脉转位(7例... 目的探讨胎儿三血管气管观对胎儿心脏大血管发育异常的诊断价值。方法分析产前筛查为胎儿大血管异常的孕妇39例,评价分析其三血管气管观的图像特征及意义。结果经尸检证实的39例大血管发育异常中,永存动脉干(7例)、大动脉转位(7例)、主动脉缩窄(5例)、法洛四联症(4例)、肺动脉狭窄(3例)、左心发育不良综合征、永存左上腔静脉、肺动脉瓣闭锁合并单心室(各2例)、三尖瓣下移畸形伴肺动脉狭窄、主动脉弓离断、右心发育不良、右位主动脉弓、动脉导管狭窄(各1例)均有不同程度三血管观异常表现。右室双出口(2例)中,仅在1例合并肺动脉狭窄时出现肺动脉内径减小。按照胎儿大血管发育异常中超声三血管气管观表现进行分类,分为大血管排列异常(10例)、大血管内径异常(21例)、大血管数目异常(9例)及大血管内血流方向异常(4例)4类。结论三血管气管观是四腔观等的有益补充,在胎儿先天性心脏病的产前超声诊断中具有重要价值。 展开更多
关键词 超声检查 产前 血管发育不良 三血管气管观
上一页 1 2 4 下一页 到第
使用帮助 返回顶部 意见反馈