急性非静脉曲张性上消化道出血患者禁食持续时间探讨  

Discussion on the duration of fasting in patients with acute non varicose upper gastrointestinal bleeding

作　　者：刘业红 申曌 Liu Yehong;Shen Zhao(Department of Gastroenterology,Huai′an First Hospital Affiliated to Nanjing Medical University,Huai′an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院消化科,淮安223300

出　　处：《中华保健医学杂志》2024年第3期316-318,共3页Chinese Journal of Health Care and Medicine

基　　金：江苏省科技项目社会发展面上项目(BE2019636)。

摘　　要：目的 观察急性非静脉曲张性上消化道出血(ANVUGIB)患者止血后早期经口进食对再出血等临床转归的影响。方法 选取南京医科大学附属淮安第一医院2020年2月~2023年8月期间120例因ANVUGIB住院患者,随机数表法分为早期进食组和常规禁食组,各60例。早期进食组内镜检查止血治疗后出血明显好转,无频繁呕吐,血流动力学稳定12 h内经口进食。常规禁食组止血后禁食水72 h,给予静脉营养。比较两组患者住院时间、再次出血率及院内死亡率。比较两组患者治疗前、治疗3 d后血钾(K+)、血钠(Na+)、血红蛋白(Hb)、白蛋白(Alb)水平。结果 两组年龄、性别、Forrest分级、出血部位及是否输血比较,差异均无统计学意义(P> 0.05)。入组时及止血后3 d两组间Hb、Alb、K+、Na+比较,差异均无统计学意义(P> 0.05)。早期进食组平均住院时间(4.92±2.07)d,低于常规禁食组的(6.15±2.83)d,组间差异有统计学意义(t=2.717,P=0.008)。两组再出血率和院内死亡率差异均无统计学意义(P> 0.05)。结论 对于急性非静脉曲张性上消化道出血患者内镜检查止血治疗后12 h内经口进食缩短了住院时间,且未提高再发出血风险和死亡率。Objective To observe the effect of early oral feeding after hemostasis on clinical outcomes such as rebleeding in patients with acute non variceal upper gastrointestinal bleeding(ANVUGIB).Methods A total of 120 hospitalized patients with ANVUGIB from February 2020 to August 2023 were randomly divided into two groups.The early feeding group(n=60)resumed oral intake within 12 hours after endoscopic examination and hemostasis treatment,without experiencing frequent vomiting and maintaining stable hemodynamics.The conventional fasting group(n=60)fasted with water for 72 hours after hemostasis and received intravenous nutrition.Hospitalization time,rebleeding rate,and hospital mortality rate were compared between the two groups.Compare the levels of blood potassium(K+),blood sodium(Na+),hemoglobin(Hb),and albumin(Alb)between the two groups before and after treatment for 3 days.Results There was no statistically significant difference in age,gender,Forrest grading,bleeding site,and whether blood transfusion was performed between the two groups(P>0.05).There was no statistically significant difference in Hb,Alb,K+,Na+between the two groups before and 3 days after treatment(P>0.05).The average hospitalization time of the early eating group was(4.92±2.07)days,which was lower than the(6.15±2.83)days of the conventional fasting group.There was a statistically significant difference between the groups(t=2.717,P=0.008).There was no statistically significant difference in rebleeding rate and hospital mortality rate between the two groups(P>0.05).Conclusion For patients with acute non-variceal upper gastrointestinal bleeding,oral feeding within 12 hours after endoscopic examination and hemostasis treatment shortenes hospitalization time without increasing the risk of recurrent bleeding and mortality.

关 键 词：急性非静脉曲张性上消化道出血 经口进食 禁食 再出血 

分 类 号：R573[医药卫生—消化系统]