Acute, nonvariceal upper gastrointestinal bleeding

作者：Klein Amir; Gralnek Ian M^*

来源：Current Opinion in Critical Care, 2015, 21(2): 154-162.

DOI：10.1097/MCC.0000000000000185

• endoscopic hemostasis
• endotherapy
• nonvariceal upper gastrointestinal hemorrhage
• peptic ulcer bleeding

Purpose of reviewAcute, nonvariceal upper gastrointestinal bleeding (UGIB) is a common medical emergency encountered worldwide. Despite medical and technological advances, it remains associated with significant morbidity and mortality.Recent findingsRapid patient assessment and management are paramount. When indicated, upper endoscopy in patients presenting with acute UGIB is effective for both diagnosis of the bleeding site and provision of endoscopic hemostasis. Endoscopic hemostasis significantly reduces rebleeding rates, blood transfusion requirements, length of hospital stay, surgery, and mortality. Furthermore, early upper endoscopy, defined as being performed within 24h of patient presentation, improves patient outcomes.SummaryA structured approach to the patient with acute UGIB that includes early hemodynamic resuscitation and stabilization, preendoscopic risk stratification using validated instruments, pharmacologic and endoscopic intervention, and postendoscopy therapy is important to optimize patient outcome and assure efficient use of medical resources.

• 出版日期2015-4