院前急救对食管胃静脉曲张大出血患者近期预后的影响  

Effect of pre-hospital care on short-term prognosis of patients with esophageal and gastric variceal bleeding

作　　者：程瑶[1] 纪桂贤[2] 王玲[1] 郝艾香 

机构地区：[1]秦皇岛市第一医院院前急救科,河北秦皇岛066000 [2]秦皇岛市第一医院消化内科,河北秦皇岛066000

出　　处：《胃肠病学和肝病学杂志》2015年第2期201-203,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨院前急救对食管胃静脉曲张大出血(esophageal and gastric variceal bleeding,EGVB)患者近期预后的影响。方法回顾性分析秦皇岛市第一医院2011年1月-2013年12月收治的EGVB患者174例,按就诊方式分为院前急救组(观察组)和自行来院组(对照组)。观察组86例:经院前止血、补液等现场急救后,转运入院;对照组88例:未经院前急救,自行或家属护送入院。两组入院后后续用药及治疗均相同,比较两组临床疗效、并发症情况。结果观察组与对照组自救反应时间、平均止血时间相比,差异无统计学意义(P>0.05);观察组第一处置时间、输血量、住院天数均少于对照组,差异有统计学意义(P<0.01);观察组死亡率13.9%,对照组15.9%,两组比较,差异无统计学意义(P>0.05),但观察组肝性脑病、肝肾综合征、感染等并发症发生率(25.6%)明显低于对照组(39.8%),差异有统计学意义(P<0.05)。结论对EGVB患者实施迅速有效的院前急救,能提高临床疗效,减少并发症,改善患者近期预后。Objective To investigate the effect of pre-hospital care on short-term prognosis of patients with esophageal and gastric variceal bleeding（ EGVB）. Methods Clinical data of 174 patients with EGVB were collected and retrospectively analyzed from Jan. 2011 to Dec. 2013. All patients were divided into the pre-hospital care group（ the observation group） and the self-going group（ the control group） according to way of admission to hospital. Eighty-six patients in the observation group received pre-hospital care,including hemostasis,fluid resuscitation and other field first aid before transferring to hospital. Eighty-eight patients in the control group had no treatment before themselves went or relatives escorted them to hospital. Two groups were treated with the same medication and treatment after entering the hospital and then the clinical efficacy and complications were compared. Results There was no significant difference in selfaid reaction time and the average time of hemostasis between two groups（ P 〉0. 05）. The first disposal time,amount of blood transfusion and hospital stay of the observation group were significantly less than those of the control group（ P〈 0. 01）. No significant difference in mortality was found between two groups（13. 9% vs 15. 9%,P 〉0. 05）,but the total incidence of hepatic encephalopathy,hepatorenal syndrome and infection was significantly lower in the observation group than in the control group（25. 6% vs 39. 8%,P〈 0. 05）. Conclusion Rapid and effective pre-hospital first aid for patients with EGVB can improve the clinical efficacy,reduce complications,thus improve the short-term prognosis of patients.

关 键 词：院前急救 食管胃静脉曲张出血 近期预后 并发症 

分 类 号：R573.2[医药卫生—消化系统]