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임상에서 비정맥류 상부위장관 출혈의 지혈클립 단독치료와 복합치료의 지혈술 비교: 관찰연구는 무작위 연구의 성적과 다른가?

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Author(s)
이수현정진태이동욱하창윤박경식이시형양창헌박윤선전성우
Keimyung Author(s)
Park, Kyung Sik
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Journal of Gastroenterology
Issued Date
2015
Volume
66
Issue
2
Keyword
Gastrointestinal hemorrhageEndoscopic hemostasis
Abstract
Background/Aims: Endoscopic hemoclip application is an effective and safe method of endoscopic hemostasis. We conducted
a multicenter retrospective study on hemoclip and hemoclip combination therapy based on prospective cohort database in
terms of hemostatic efficacy not in clinical trial but in real clinical practice.
Methods: Data on endoscopic hemostasis for non-variceal upper gastrointestinal bleeding (NVUGIB) were prospectively collected
from February 2011 to December 2013. Among 1,584 patients with NVUGIB, 186 patients treated with hemoclip were enrolled
in this study. Subjects were divided into three groups: Group 1 (n=62), hemoclipping only; group 2 (n=88), hemoclipping
plus epinephrine injection; and group 3 (n=36), hemocliping and epinephrine injection plus other endoscopic hemostatic
modalities. Primary outcomes included rebleeding, other therapeutic management, hospitalization period, fasting period and
mortality. Secondary outcomes were bleeding associated mortality and overall mortality.
Results: Active bleeding and peptic ulcer bleeding were more common in group 3 than in group 1 and in group 2 (p<0.001).
However, primary outcomes (rebleeding, other management, morbidity, hospitalization period, fasting period and mortality)
and secondary outcomes (bleeding associated mortality and total mortality) were not different among groups.
Conclusions: Combination therapy of epinephrine injection and other modalities with hemoclips did not show advantage over
hemoclipping alone in this prospective cohort study. However, there is a tendency to perform combination therapy in active
bleeding which resulted in equivalent hemostatic success rate, and this reflects the role of combination therapy in clinical
practice.
Alternative Title
Comparison on Endoscopic Hemoclip and Hemoclip Combination Therapy in Non-variceal Upper Gastrointestinal Bleeding Patients Based on Clinical Practice Data: Is There Difference between Prospective Cohort Study and Randomized Study?
Keimyung Author(s)(Kor)
박경식
Publisher
School of Medicine
Citation
이수현 et al. (2015). 임상에서 비정맥류 상부위장관 출혈의 지혈클립 단독치료와 복합치료의 지혈술 비교: 관찰연구는 무작위 연구의 성적과 다른가? Korean Journal of Gastroenterology, 66(2), 85–91. doi: 10.4166/kjg.2015.66.2.85
Type
Article
ISSN
1598-9992
DOI
10.4166/kjg.2015.66.2.85
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32926
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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