急性非静脉曲张性上消化道再出血患者死亡的危险因素分析  

Analysis of Risk Factors for Death of Patients with Acute Nonvariceal Upper Gastrointestinal Rebleeding

作　　者：聂丽芬 张晓燕 黎铭恩 

机构地区：[1]暨南大学医学院附属广州红十字会医院,广东广州510220

出　　处：《中国医学创新》2016年第8期60-63,共4页Medical Innovation of China

摘　　要：目的:探讨急性非静脉曲张性上消化道出血(ANVU GIB)再出血患者死亡的危险因素。方法:回顾性分析1994年8月-2014年12月本院收治的210例ANVU GIB再出血患者的临床资料,按治疗结局将患者分为治愈组及死亡组,同时应用Logistic多因素分析影响其死亡的危险因素。结果:210例ANVU GIB再出血患者死亡率为21.43%(45/210)。两组患者在性别、年龄、吸烟史、饮酒史等方面比较差异均无统计学意义(P>0.05);在合并重要器官疾病、首次出血后内镜下止血治疗、再出血前血红蛋白含量等方面比较差异有统计学意义(P<0.05)。其中合并重要器官疾病、首次出血后内镜下止血治疗、再出血前血红蛋白含量、再出血后休克、再出血后有效止血时间是ANVU GIB再出血死亡的独立危险因素(P<0.05)。结论:合并重要器官疾病、首次出血后内镜下止血治疗、再出血前血红蛋白含量、再出血后休克、再出血后有效止血时间是ANVU GIB再出血死亡的独立危险因素,临床上应重视ANVU GIB再出血病情评估,积极进行有效止血治疗以降低死亡率。Objective： To identify risk factors for death of patients with ANVU GIB re-bleeding. Method： The clinical data for 210 patients with ANVU GIB re-bleeding were selected in our hospital from August 1994 to December 2014, according to the treatment outcome the patients were divided into cure group and death group, the risk factors for death of ANVU GIB re-bleeding were analyzed by multivariate analyses.Result： The mortality rate was 21.43% （ 45/210 ） . Two groups of patients in gender, age, smoking history, drinking history comparative differences had no statistical significance （ P〉0.05 ）, and in Underlying diseases of vitals, endoscopic hemostatic treatment afer first bleeding, hemoglobin value before re-bleeding had statistical differences （ P〈0.05 ） . Underlying diseases of vitals, endoscopic hemostatic treatment afer first bleeding, hemoglobin value before re- bleeding, shock afer re-bleeding, valid hemostatic time afer re-bleeding were independent risk factors for death with ANVU GIB re-bleeding （P〈0.05） .Conclusion： Underlying diseases of vitals, endoscopic hemostatic treatment after first bleeding, hemoglobin value before re-bleeding, shock after re-bleeding, valid hemostatic time after re-bleeding are independent risk factors for death in patients with ANVU GIB re-bleeding, the evaluation of patient＇s condition should be valued highly, and effective treatment to stanch bleeding should be put into execution positively to lower the mortality.

关 键 词：急性非静脉曲张性上消化道出血 再出血 死亡 危险因素 

分 类 号：R573.2[医药卫生—消化系统]