講 師：陳建安 醫師
課程大綱(約100-200字)：
2021 Updated clinical guideline of Upper Gastrointestinal and Ulcer Bleeding by The American College of Gastroenterology suggest:
1. patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) who are classified as very low risk, defined as a risk assessment score with #1% false negative rate for the outcome of hospital-based intervention or death (e.g., Glasgow-Blatchford score 0–1), be discharged with outpatient follow-up rather than admitted to hospital.
2. a restrictive policy of red blood cell transfusion with a threshold for transfusion at a hemoglobin of 7 g/dL for patients with UGIB.
3. an infusion of erythromycin before endoscopy in patients with UGIB.
4. ACG guideline could not reach a recommendation for or against pre-endoscopic PPI therapy for patients with UGIB.
5. patients admitted to or under observation in hospital for UGIB undergo endoscopy within 24 hr of presentation.
6. endoscopic therapy in patients with UGIB due to ulcers with active spurting, active oozing, and nonbleeding visible vessels.
7. ACG guideline could not reach a recommendation for or against endoscopic therapy in patients with UGIB due to ulcers with adherent clot resistant to vigorous irrigation.
8. epinephrine injection not be used alone for patients with UGIB due to ulcers but rather in combination with another hemostatic modality.
9. high-dose PPI therapy given continuously or intermittently for 3 d after successful endoscopic hemostatic therapy of a bleeding ulcer.
10. high-risk patients with UGIB due to ulcers who received endoscopic hemostatic therapy followed by short-term high-dose PPI therapy in hospital continue on twice-daily PPI therapy until 2 wk after index endoscopy.
