介入治疗在难治性急性非静脉曲张性上消化道出血中的应用价值  

The application value of interventional therapy in refractory acute nonvariceal upper gastrointestinal bleeding

作　　者：林婵婵 张葵玲[1] 陈小令 苏雅青 朱晓东 陈新琦 LIN Chanchan;ZHANG Kuiling;CHEN Xiaoling;SU Yaqing;ZHU Xiaodong;CHEN Xinqi(Department of Gastroenterology,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,Fujian,China)

机构地区：[1]福建医科大学附属泉州第一医院消化内科,福建泉州362000

出　　处：《中国现代医生》2023年第31期56-59,共4页China Modern Doctor

摘　　要：目的探讨介入治疗在难治性急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)中的应用价值。方法回顾性选取2019年1月至2022年9月于福建医科大学附属泉州第一医院诊治的难治性ANVUGIB患者70例,根据其治疗方式的不同,将其分为介入治疗组(n=31)和外科手术组(n=39)。比较两组患者的基本资料、再出血发生率、治疗相关并发症发生率及不愈率。结果介入治疗组患者的年龄、Blatchford评分、合并恶性肿瘤/重大基础疾病的比例均显著高于外科手术组(P<0.05)。介入治疗组患者的再出血率和不愈率高于外科手术组,但两组比较差异均无统计学意义(P>0.05)。介入治疗组患者的术后并发症发生率显著低于外科手术组(P<0.05)。结论对高龄、合并严重基础疾病或合并症、Blatchford评分高、预计并发症发生风险高的难治性ANVUGIB患者,介入治疗可作为首选治疗措施。Objective To investigate the application value of interventional therapy in refractory acute nonvariceal upper gastrointestinal bleeding(ANVUGIB).Methods Seventy patients with refractory ANVUGIB who were treated in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to September 2022 were retrospectively selected and divided into interventional treatment group(n=31)and surgical operation group(n=39)according to different treatment methods.The basic data,the rate of rebleeding,the rate of treatment-related complications and the rate of non-healing were compared between the two groups.Results Age,Blatchford score,and proportion of patients with malignant tumor/major underlying disease in interventional treatment group were significantly higher than those in surgical operation group(P<0.05).The rebleeding rate and non-healing rate of interventional treatment group were higher than those of surgical operation group,but there was no statistical significance between the two groups(P>0.05).The incidence of postoperative complications in interventional treatment group was significantly lower than that in surgical operation group(P<0.05).Conclusion For refractory ANVUGIB patients who are elderly,have serious underlying diseases or comorbidities,have a high Blatchford score,and have a high risk of complications,interventional therapy can be the first choice of treatment.

关 键 词：介入治疗 急性非静脉曲张性上消化道出血 手术治疗 

分 类 号：R573.2[医药卫生—消化系统]