消化性溃疡伴出血患者的临床特点及内镜特征分析  

Clinical Characteristics and Endoscopic Analysis of Patients with Peptic Ulcer Accompanied by Bleeding

作　　者：张春芬 王保永 ZHANG Chunfen;WANG Baoyong(Department of Gastroenterology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院消化内科,河南洛阳471000

出　　处：《河南医学研究》2024年第17期3165-3168,共4页Henan Medical Research

摘　　要：目的分析消化性溃疡伴出血患者的临床特点及内镜特征。方法回顾性收集2018年9月至2023年1月郑州大学附属洛阳中心医院收治的经内镜检查确诊的86例消化性溃疡伴出血患者资料,另收集同期确诊的86例消化性溃疡未伴出血患者资料。比较两组临床特点,观察消化性溃疡伴出血患者的内镜特征(Forrest分级情况),对比不同内镜特征患者近期再出血发生情况。结果消化性溃疡出血患者饮酒史、巨大溃疡及幽门螺杆菌(Hp)感染占比高于消化性溃疡未伴出血患者(P<0.05);经内镜检查发现,86例消化性溃疡伴出血患者中高危溃疡(Ⅰa~Ⅱb)34例,占比39.54%,低危溃疡(Ⅱc~Ⅲ)52例,占比60.46%。高危溃疡患者近期再出血发生率高于低危溃疡患者(P<0.05)。结论消化性溃疡伴出血患者多有饮酒史、呈巨大溃疡,且多伴有Hp感染,中高危患者近期内仍有较高的再出血风险,临床应重视消化性溃疡伴出血患者的内镜检查,针对内镜提示中高危者,应做好再出血防治工作。Objective To analyze the clinical and endoscopic characteristics of patients with peptic ulcer accompanied by bleeding.Methods A retrospective collection of data was conducted on 86 patients diagnosed with peptic ulcers and bleeding through endoscopic examination admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from September 2018 to January 2023.And the data of 86 patients diagnosed with peptic ulcers without bleeding during the same period were collected.The clinical characteristics of the two groups were compared.The endoscopic features(Forrest classification)of patients with peptic ulcer complicated with bleeding were observed.The recent rebleeding of patients with different endoscopic features was compared.Results Patients with peptic ulcer bleeding had a higher proportion of alcohol consumption history,massive ulcers,and Helicobacter pylori(Hp)infection compared to patients without peptic ulcer bleeding(P<0.05).Through endoscopic examination,it was found that among 86 patients with peptic ulcers and bleeding,34 cases were medium to high risk ulcers(Ⅰa-Ⅱb),accounting for 39.54%,and 52 cases were low risk ulcers(Ⅱc-Ⅲ),accounting for 60.46%.The incidence of recurrent bleeding in medium to high risk ulcer patients was higher than that in low risk ulcer patientse(P<0.05).Conclusion Patients with peptic ulcers and bleeding often have a history of alcohol consumption,large ulcers,and are often accompanied by Hp infection.Medium to high risk patients have a high risk of re-bleeding in the near future.Clinical attention should be paid to endoscopic examination of patients with peptic ulcers and bleeding,and prevention and treatment of re-bleeding should be done well for high-risk patients indicated by endoscopy.

关 键 词：消化性溃疡 出血 临床特点 内镜特征 

分 类 号：R574.1[医药卫生—消化系统]