ICU急性上消化道大出血床旁胃镜疗效及安全性的观察  

Value and Safety of the Bedside Gastroscopes Treatment for Acute Upper Gastrointestinal Bleeding in ICU

作　　者：桂培根[1] 张凯[1] 吴正茂[1] 莫黎[1] 罗勇[1] 张群峰[1] 

机构地区：[1]南华大学附属第二医院重症医学科,湖南衡阳421001

出　　处：《中南医学科学杂志》2015年第5期556-558,569,共4页Medical Science Journal of Central South China

摘　　要：目的回顾性探讨危重症患者急性上消化道大出血床旁胃镜下检查和救治的疗效及安全性。方法对我院2006年3月至2014年3月间422例常规内科治疗难以控制的急性上消化道大出血患者临床资料进行回顾性分析,非静脉曲张性上消化道大出血354例,静脉曲张性上消化道大出血68例,观察止血出血情况,维持>72 h为止血成功,<72 h为暂时止血,仍有出血为无效。结果非静脉曲张性上消化道大出血止血成功率为86.01%,静脉曲张性上消化道大出血止血成功率为66.18%。结论 ICU医生床旁紧急胃镜下检查及胃镜下联合止血治疗是安全有效的,能显著提高患者的救治成功率。Objective To retrospectively evaluate the therapeutic effect and security of the application of the bedside gastroscopes in the examination and therapy among these critical patients with acute upper gastrointestinal bleeding.Methods The clinic data for 422 patients who difficult to control acute upper gastrointestinal bleeding during Mrach 2006 to February 2014 were retrospectively,including 354 cases non-varicose upper gastrointestinal bleeding in the bedside gastroscopes group underwent the bedside gastroscopes therapy. 68 cases varicose upper gastrointestinal bleeding were treated by either surgery or gastroscopes in the control group. Hemostasis were observed in all the patients of the two groups. If maintence time is over 72 h,the therapy is effective,on the contrary,it is judged to be invalid. Results Hemostasis rate of non-varicose acute upper gastrointestinal bleeding and varicose acute upper gastrointestinal bleeding were respectively86. 01% and 66. 18% in the bedside gastroscopes group,which were higher than those of control group（ P 0. 05）.Conclusion The bedside gastroscopes therapy is a safe and effective treatment for critical patients with acute upper gastrointestinal bleeding and is worth to recommend.

关 键 词：床旁胃镜 急性上消化道出血 联合止血 

分 类 号：R651.15[医药卫生—外科学] R459.3[医药卫生—临床医学]