急诊消化内镜治疗非静脉曲张性上消化道出血的效果研究  

Study on the Efficacy of Emergency Digestive Endoscopy in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding

作　　者：何璐 李德宾 黄腾飞 HE Lu;LI Debin;HUANG Tengfei(Lianjiang General Hospital,Fuzhou 350500,China;The 900th Hospital of the Joint Logistic Support Force of PLA,Fuzhou 350500,China)

机构地区：[1]连江县总医院,福建福州350500 [2]中国人民解放军联勤保障部队第九〇〇医院,福建福州350500

出　　处：《中华灾害救援医学》2025年第1期74-77,共4页Chinese Journal of Disaster Medicine

摘　　要：目的 探讨、分析急诊消化内镜治疗上消化道出血的临床效果。方法 选取2023年8月至2024年8月连江县总医院收治的92例上消化道出血患者为研究对象,以治疗方案为分组依据,分为研究组(采用急诊内镜治疗)与对照组(采取药物治疗),每组各46例。对比两组患者临床恢复相关指标、凝血相关指标、氧化应激相关指标、临床疗效情况、不良事件发生情况。结果 治疗后,与对照组患者相比,研究组患者控制出血、恢复肠鸣音、彻底止血、住院时间均更短(P<0.001),输血量更少(P<0.001);两组患者纤维蛋白原水平均恢复正常水平,但研究组升高更显著(P<0.001)。治疗后,两组患者凝血酶时间、凝血酶原时间、活化部分凝血酶原时间以及抗利尿激素、丙二醛水平均明显降低,但与对照组患者相比,研究组患者各项指标降低更显著(P<0.001);另外,研究组患者的临床总有效率更高,不良事件总发生率更低(P<0.05)。结论 对于上消化道出血患者,急诊消化内镜治疗可缩短临床恢复时间和住院时间,改善凝血和氧化、应激相关指标,提高止血效率,降低不良事件的发生风险。Objective To explore and analyze the clinical efficacy of emergency gastrointestinal endoscopy in the treatment of upper gastrointestinal bleeding(UGIB).Methods A total of 92 patients with UGIB who were treated at Lianjiang County General Hospital from August 2023 to August 2024 were selected for this study.Patients were divided into two groups based on their admission sequence:the study group(n=46),who received emergency endoscopic treatment,and the control group(n=46),who were treated with medication.The clinical recovery indicators,coagulation-related parameters,oxidative stress markers,clinical efficacy,and the incidence of adverse events were compared between the two groups.Results Compared with the control group,the study group showed significantly shorter times to control bleeding,restore bowel sounds,achieve complete hemostasis,and shorter hospital stays(P<0.001).The amount of blood transfusion was also significantly lower in the study group(P<0.001).Both groups showed recovery of fibrinogen levels to normal,but the increase in the study group was more significant(P<0.001).The study group also demonstrated more significant reductions in thrombin time,prothrombin time,activated partial thromboplastin time,as well as levels of antidiuretic hormone and malondialdehyde,compared to the control group(P<0.001).The clinical overall efficacy rate was higher in the study group,and the total incidence of adverse events was lower(P<0.05).Conclusion Emergency gastrointestinal endoscopy for patients with UGIB can shorten clinical recovery time and hospital stay,improve coagulation and oxidative stress-related indicators,enhance hemostasis efficiency,and reduce the risk of adverse events.

关 键 词：胃肠出血 纤维蛋白原 凝血酶时间 

分 类 号：R459.7[医药卫生—急诊医学]