剖腹探查结合术中肠镜在消化道出血诊疗的应用及RBC、Hb和HCT改变  

Application of exploratory laparotomy combined with intraoperative enteroscopy in diagnosis and treatment of gastrointestinal bleeding and changes of RBC,Hb and HCT

作　　者：吴天山[1] 杨杰[1] 马宏飞[1] 郭飞[1] WU Tianshan;YANG Jie;MA Hongfei;GUO Fei(Emergency Trauma Surgery,Xinjiang Medical University,the First Affiliated Hospital,Urumchi,Xinjiang,China,830054)

机构地区：[1]新疆医科大学第一附属医院急诊创伤外科,新疆乌鲁木齐830054

出　　处：《分子诊断与治疗杂志》2022年第3期443-446,共4页Journal of Molecular Diagnostics and Therapy

基　　金：新疆维吾尔自治区自然科学基金资助项目(2019D01C304)。

摘　　要：目的探讨剖腹探查结合术中肠镜在消化道出血诊疗的应用及RBC、Hb和HCT改变。方法选取2019年2月至2021年4月新疆医科大学第一附属医院附属医院创伤急救中心收治的89例消化道出血患者为观察组。于同期选取行常规肠镜检查的30例消化道出血患者为对照组。比较两组患者手术情况及疗效的差异,分析治疗前后RBC、Hb和HCT变化。结果观察组总有效率(94.38%)显著高于对照组(50.0%),差异有统计学意义(P<0.05);治疗前,两组RBC、Hb及HCT水平变化比较差异无统计学意义(P>0.05);治疗后1周、治疗后1个月RBC、Hb及HCT水平较治疗前显著升高(P<0.05),且观察组治疗后1周、1个月RBC、Hb及HCT水平显著高于对照组,差异有统计学意义(P<0.05);中重度出血量患者RBC、Hb和HCT水平显著低于轻度出血量患者,差异有统计学意义(P<0.05)。结论消化道出血患者可采取剖腹探查结合术中肠镜的方式,临床诊治率较高,可有效减少RBC、Hb和HCT流失。Objective To explore the application of laparotomy combined with intraoperative enteroscopy in the diagnosis and treatment of gastrointestinal bleeding and the changes of RBC,Hb and HCT.Methods From February 2019 to April 2021,89 patients with gastrointestinal bleeding admitted to the Trauma Emergency Center of the First Affiliated Hospital of Xinjiang Medical University were selected as the research objects.In the same period,30 patients with gastrointestinal bleeding who underwent routine colonoscopy were selected as the control group.The differences in surgical conditions and curative effects between the two groups were compared,and the changes of RBC,Hb and HCT before and after treatment were analyzed.Results The total effective rate(94.38%)in the observation group was significantly higher than that in the control group(50.0%),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the changes of RBC,Hb and HCT levels between the two groups(P>0.05).The levels of RBC,Hb and HCT at 1 week and 1 month after treatment were significantly higher than those before treatment(P<0.05),but the levels of RBC,Hb and HCT in the observation group were significantly higher than those in the control group at 1 week and 1 month after treatment,the difference was statistically significant(P<0.05).The levels of RBC,Hb and HCT in patients with moderate and severe bleeding were significantly lower than those in patients with mild bleeding,and the difference was statistically significant(P<0.05).Conclusion Patients with gastrointestinal hemorrhage can adopt laparotomy combined with intraoperative colonoscopy.The clinical diagnosis and treatment rate is relatively high,which can effectively reduce the loss of RBC,Hb and HCT.

关 键 词：剖腹探查 术中肠镜 消化道出血 RBC HB HCT 

分 类 号：R656[医药卫生—外科学]