不同胃镜诊治时机对急诊上消化道出血患者预后的影响  

Effects of Different Timings of Gastroscopy for Diagnosis and Treatment on the Prognosis of Patients with Upper Gastrointestinal Bleeding

作　　者：孙秀丽[1] 蒋波[2] 王红[1] 孙咏红[1] SUN Xiu-li;JIANG Bo;WANG Hong;SUN Yong-hong(Department of Gastroenterology,Dalian Municipal Friendship Hospital,Dalian,Liaoning 116001,China;Department of Nursing,Dalian Municipal Friendship Hospital,Dalian,Liaoning 116001,China)

机构地区：[1]大连市友谊医院消化内科,辽宁大连116001 [2]大连市友谊医院护理部,辽宁大连116001

出　　处：《解放军医药杂志》2020年第3期92-95,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：辽宁省自然科学基金项目(201503212)。

摘　　要：目的研究不同胃镜诊治时机对急诊上消化道出血(UGB)患者预后的影响。方法选取2016年2月—2018年2月诊治174例UGB患者的临床资料进行回顾性分析。根据胃镜检查时机不同进行分组,其中急诊组(出血8 h内)62例,早期组(出血8~24 h)58例,晚期组(出血超过24 h)54例。比较3组的出血部位检出情况、治疗效果、并发症情况、再出血和死亡发生率。结果3组上消化道出血原因、出血位置、止血成功率、并发症和死亡发生率比较差异均无统计学意义(P>0.05)。急诊组检出率高于早期组和晚期组,检出时间、输血量和住院时间均低于早期组和晚期组,早期组检出时间、输血量和住院时间低于晚期组(P<0.05)。急诊组再出血发生率低于晚期组(P<0.05)。结论出血8 h内行胃镜诊治可提高出血灶检出率和止血效果,并能够减少输血操作、住院时间及再出血发生率,有利于UGB患者身心健康。Objective To study the effects of different application timings of gastroscopy for diagnosis and treatment on prognosis of patients with emergency upper gastrointestinal bleeding(UGB).Methods The clinical data of 174 UGB patients who were treated from February 2016 to February 2018 were analyzed retrospectively.According to different application timings of gastroscopy,they were divided into emergency group(bleeding within 8 h,n=62),early UGB group(bleeding within 8 to 24 h,n=58),and late UGB group(bleeding for more than 24 h,n=54).The detection of bleeding site,treatment effect,complications,rebleeding and death rate were compared among the three groups.Results There was no significant difference in the cause of bleeding,bleeding sites,success rate of hemostasis,complications and death rates of UGB among the three groups(P>0.05).The detection rate of the emergency group was higher than that of the early UGB group and the late UGB group,and the duration of detection,transfusion volume and the length of hospital stay were shorter or lower than those of the early UGB group and the late UGB group,while the duration of detection,transfusion volume and the length of hospital stay of the early UGB group were shorter or lower than those of the late UGB group(P<0.05).The incidence rate of rebleeding in emergency group was lower than that in late UGB group(P<0.05).Conclusion In the diagnosis and treatment,gastroscopy performed within 8 h of bleeding can improve the detection rate of bleeding lesions and hemostasis effects,and reduce the transfusion operation,the length of hospital stay and the incidence of rebleeding,which is conducive to the physical and mental health of UGB patients.

关 键 词：上消化道出血 胃镜检查 止血 内窥镜 诊断 预后 

分 类 号：R573.2[医药卫生—消化系统]