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First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases

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World Journal of Gastroenterology 2016年第41期22卷 9162-9171页

作者： Hans-Jürgen Richter-Schrag Torben Glatz christine walker Andreas Fischer Robert Thimme Center of Interdisciplinary Gastrointestinal Endoscopy Department of Medicine II Medical Center-University of Freiburg Faculty of Medicine University of Freiburg Department of General and Visceral Surgery Medical Center-University of Freiburg Faculty of Medicine University of Freiburg

AIM To evaluate rebleeding, primary failure(PF) and mortality of patients in whom over-the-scope clips(OTSCs) were used as first-line and second-line endoscopic treatment(FLET, SLET) of upper and lower gastrointestinal bleeding(UGIB, LGIB).METHODS A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016(n= 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC *** Primary hemostasis and clinical success of bleeding lesions(without rebleeding) was achieved in 88/100(88%) and 78/100(78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET(4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET(OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7(35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated *** Our data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure.

关键词： Gastrointestinal bleeding Rockall risk score Over-the-scope clip First-line endoscopic treatment Second-line endoscopic treatment

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酚化合物对烟草燃烧的影响

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中国烟草学报 2006年第4期12卷 34-34页

作者： christine A. LITTLE Alexander J. Dyakonov Rana T. walker Florian R. Perini D. Scott Passer Jun Guan 吴晓芸（译）曹建平（校） Lorillard烟草公司格林斯博罗北卡罗来纳州不详

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