大面积烧伤并发消化道出血行介入手术治疗的临床分析  

Clinical analysis of interventional therapy for gastrointestinal hemorrhage complicated by extensive burns

作　　者：赵江生 裴永东[1] 丁祥生[1] ZHAO Jiangsheng;PEI Yongdong;DING Xiangsheng(Department of Burn and Plastic Surgery,The First People's Hospital of Lianyungang,Lianyungang,Jiangsu 222000,China)

机构地区：[1]连云港市第一人民医院烧伤整形科,江苏连云港222000

出　　处：《手术电子杂志》2024年第5期29-33,共5页Electronic Journal of Medical Operations

摘　　要：目的 探讨重度烧伤患者并发消化道出血行介入治疗的疗效。方法 纳入2020年1月—2024年7月连云港市第一人民医院收治的重度烧伤患者239例中并发消化道出血的患者36例作为研究对象,根据治疗方法的不同将其分为对照组21例和研究组15例,对照组接受消化内镜止血治疗,研究组接受血管介入下治疗。比较两组患者发病时入院天数、出血表现、血凝功能、止血效果、临床症状改善情况、再出血以及并发症等情况。结果 研究组中有休克表现者占比93.3%(14/15),对照组中休克患者占比61.9%(13/21),具有统计学差异(P<0.05);研究组中主要表现为呕血的患者比例为66.7%(10/15),对照组中主要表现为呕血的患者比例为28.6%(6/21),有统计学差异(P<0.05);研究组粪便隐血转阴时间以及肠鸣音恢复时间均小于对照组,具有统计学意义(P<0.05);研究组止血显著有效率93.3%,有效率6.7%(1/15),对照组依次为52.4%(11/21)及42.9%(9/21),无效率为4.8%(1/21),差异具有统计学意义(P<0.05)。研究组术后再出血发生率为6.7%(1/15),对照组为38.1%(8/21),具有统计学差异(P<0.05)。结论 对于重度烧伤并发消化道出血的患者,考虑存在活动性动脉性出血时行介入栓塞止血相较于内镜下止血效果更好,再出血发生率更低。Objective To explore the efficacy of interventional therapy for severe burn patients with gastrointestinal bleeding.Methods A total of 239 patients with severe burns were treated in The First People's Hospital of Lianyungang from January 2020 to July 2024,and 36 of them who suffered gastrointestinal bleeding were included in this study.According to the different treatment methods,21 patients were assigned to the control group and 15 patients were assigned to the research group.The control group received endoscopic treatment,and the research group received interventional vascular embolization.The two groups were compared in terms of the days at the time of onset,bleeding manifestations,blood coagulation function,therapeutic effect,improvement of clinical symptoms,occurrence of rebleeding and complications.Results The percentage of patients with shock was 93.3%(14/15)in the research group and 61.9%(13/21)in the control group,which was statistically different(P<0.05).The percentage of patients who vomited blood was 66.7%(10/15)in the research group and 28.6%(6/21)in the control group,which was statistically different(P<0.05).The time for the patients in the research group to become negative for fecal occult blood test and the time for the return of bowel sounds were less than those of the control group,which were statistically significant(P<0.05).For the treatment effect,the research group had a significant effective rate of 93.3%and an effective rate of 6.7%(1/15),while in the control group they were 52.4%(11/21)and 42.9%(9/21)respectively,the ineffective rate was 4.8%(1/21),and the differences were statistically significant(P<0.05).The incidence of postoperative rebleeding was 6.7%in the research group(1/15),and 38.1%(8/21)in the control group,which was statistically different(P<0.05).Conclusion For patients with severe burns combined with gastrointestinal bleeding,when active arterial bleeding is suspected,interventional vascular embolization is more effective and has a lower incidence of rebleeding compared with

关 键 词：烧伤 消化道出血 介入治疗 

分 类 号：R47[医药卫生—护理学]