肩肘外科手术后并发上消化道出血的临床分析  

Clinical analysis of postoperative upper gastrointestinal bleeding(UGIB)after shoulder and elbow surgery

作　　者：张媛媛[1] 刘心怡 张黎明[1] 吴芸 刘玉兰[1] Zhang Yuanyuan;Liu Xinyi;Zhang Liming;Wu Yun;Liu Yulan(Department of Gastroenterology, Peking University People's Hospital, Beijing 100044,China)

机构地区：[1]北京大学人民医院消化科,100044

出　　处：《中华肩肘外科电子杂志》2018年第1期54-58,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

摘　　要：目的分析肩肘外科手术后并发上消化道出血的临床特点,并分析其危险因素。方法回顾性分析2007年1月至2015年12月于北京大学人民医院行肩肘外科手术治疗后并发上消化道出血患者的临床资料,总结其临床特点,分析引起上消化道出血的危险因素。结果肩肘外科术后发生上消化道出血共33例,发生率为3.36%(33/983);单因素分析显示高龄、性别、手术时间长、吸烟史、饮酒史、消化性溃疡或出血史、应用抗凝药物或抗血小板药物等因素与肩肘外科手术患者术后发生上消化道出血明显相关(P<0.05);非条件多因素Logistic分析结果显示高龄、性别、手术时间长、消化性溃疡或出血史、应用抗凝药物或抗血小板药物是肩肘外科手术患者术后发生上消化道出血的独立危险因素(P<0.05)。结论肩肘外科手术患者术后发生上消化道出血较为少见,高龄、性别、手术时间长、消化性溃疡或出血史、应用抗凝药物或抗血小板药物是肩肘外科手术患者术后发生上消化道出血的独立危险因素。Background Upper gastrointestinal bleeding(UGIB)is one of the seriouscomplications after major orthopedic operation,which is mainly caused by stress-related ulcer(SU).While showing no symptom in mild cases,UGIB can affect the rehabilitation and life of patients incritical cases.The symptoms of UGIB are usually hard to be detected during the early postoperativestage,which brings some difficulties to the diagnosis and treatment.Usually,more cases of UGIB arereported after major orthopedic surgery.Shoulder and elbow surgery is in rapid development recently,and most of them are small and medium surgeries including internal fixation of peripheral shoulderand elbow fractures,ligament injuries of peripheral shoulder and elbow,repair and reconstruction ofrotator cuff injury,shoulder and elbow arthroplasties,etc.Thus,the postoperative UGIB is seldomlyreported in these cases.Clinically,the application of prophylactic drug on every patient with shoulderand elbow surgery in avoiding digestive tract bleeding will cause unnecessary medical waste.Thisstudy retrospectively analyzed the clinical data of shoulder and elbow surgery in our hospital for nearly8years and collected the high-risk factors of postoperative UGIB to better grasp the clinical data ofUGIB after shoulder and elbow surgery,prevent postoperative UGIB,and optimize the guideline ofclinical individualized treatment.Methods(1)Research object.From January1,2007to December12,2015,the information of patients with shoulder and elbow surgery under the department of orthopedics andtraumatology was collected,and the patients with UGIB were included in this study.Inclusive and exclusivecriteria:within one week after operation,the patients had situations including hematemesis,melena and positiveoccult test.The bleeding of mouth,nasopharynx and biliary tract as well as preoperative active peptic ulcer andgastrointestinal bleeding should be excluded.(2)Research methods.The general and clinical data of patients were statistically analyzed.The general data includes demographic c

关 键 词：肩肘外科 并发症 应激性溃疡 上消化道出血 

分 类 号：R573.2[医药卫生—消化系统]