检索结果-南通市图书馆

Management of non-variceal upper gastrointestinal tract hemorrhage:Controversies and areas of uncertainty

World Journal of Gastroenterology 2012年第11期18卷 1159-1165页

作者： Eric P Trawick Patrick S Yachimski Division of Gastroenterology Hepatology and NutritionVanderbilt University Medical Center

Upper gastrointestinal tract hemorrhage （UGiH） remains a common presentation requiring urgent evaluation and treatment. Accurate assessment, appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge. The advent of pharmacologic acid suppression, endoscopic hemostatic techniques, and recognition of helicobacter pylori as an etiologic agent in peptic ulcer disease （PUD） has revolutionized the treatment of UGiH. Despite this, acute UGiH still carries considerable rates of morbidity and mortality. This review aims to discuss current areas of uncertainty and controversy in the management of UGiH. Neoadjuvant proton pump inhibitor （PPi） therapy has become standard empiric treatment for UGiH given that PUD is the leading cause of non variceal UGiH, and PPis are extremely effective at promoting ulcer healing. Howeve, neoadjuvant PPi administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality. The optimal timing of upper endoscopy in UGiH is often debated. Upon completion of volume resuscitation and hemodynamic stabilization, upper endoscopy should be performed within 24 h in all patientswith evidence of UGiH for both diagnostic and therapeutic purposes. With rising healthcare cost paramount in today＇s medical landscape, the ability to appropriately triage UGiH patients is of increasing value. Upper en- doscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low risk lesions or admission for further moni toring and treatment in higher risk lesions. Concomitant pharmacotherapy with non steroidal antiinflammatory drugs （NSAiDs） and antiplatelet agents, such as clopidogrel, has a major impact on the etiology, severib/, and potential treatment of UGiH. Long term PPi use in patients taking chronic NSAiDs or clopidogrel is discussed thoroughly in this review.

关键词： hemorrhage Proton pump inhibitors he/i-cobacter py/ori Prokinetic agents hemostasis Thieno-pyridines

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：