不同评分在门、急诊下消化道出血患者的诊疗价值  

Value of Different Scores in the Diagnosis and Treatment of Patients with Lower Gastrointestinal Hemorrhage in Outpatient and Emergency Department

作　　者：陈思源 彭琼[1] 贾逸文 冯广铭 CHEN Siyuan;PENG Qiong;JIA Yiwen;FENG Guangming(Department of Gastroenterology,Hefei First People's Hospital,Hefei 230001,Anhui,China)

机构地区：[1]合肥市第一人民医院消化内科,安徽合肥230001

出　　处：《医学信息》2025年第9期87-91,共5页Journal of Medical Information

基　　金：2019年度合肥市卫生健康应用医学研究项目(编号:hwk2019zc004)。

摘　　要：目的研究Oakland评分和Sengupta评分在急性下消化道出血患者预后评估中的临床应用价值。方法选取本院2021年1月-2023年6月门、急诊就诊的464例主诉便血患者,将医嘱住院治疗的254例列为住院组,医嘱居家观察的210例列为居家组。记录患者的临床资料,并计算患者的Oakland评分和Sengupta评分,评价2个评分的应用效果。结果住院组患者的Oakland评分、Sengupta评分高于居家组,差异有统计学意义(P<0.01)。Oakland评分预测是否为严重出血、再出血、30天死亡的AUC面积(95%置信区间)分别为0.952、0.811、0.853(P<0.05)。预测的最佳截断值分别为19.5分、15.5分、19.5分。Sengupta评分预测是否为严重出血、再出血、30天死亡的AUC面积(95%置信区间)分别为0.863、0.793、0.871(P<0.05),预测的最佳截断值分别为3.5分、7.5分、6.5分。结论Oakland和Sengupta评分在预测急性下消化道出血严重出血、再出血、30天死亡有一定的价值,Oakland评分预测急性下消化道出血严重出血的价值优于Sengupta评分,两个评分在预测急性下消化道出血再出血、30天死亡的价值相当。Objective To study the clinical application value of Oakland score and Sengupta score in the prognosis evaluation of patients with acute lower gastrointestinal hemorrhage.Methods A total of 464 patients with chief complaint of hematochezia who were admitted to the outpatient and emergency departments of our hospital from January 2021 to June 2023 were selected,while 254 patients who were hospitalized according to the doctor's advice were included in the inpatient group,and 210 patients who were observed at home according to the doctor's advice were included in the home group.The clinical data of the patients were recorded,and the Oakland score and Sengupta score of the patients were calculated to evaluate the application effect of the two scores.Results The Oakland score and Sengupta score of the hospitalized group were higher than those of the home group,and the difference were statistically significant(P<0.01).The AUC area(95%confidence interval)of the Oakland score for predicting severe bleeding,rebleeding,and 30-day death were 0.952,0.811,and 0.853,respectively(P<0.05),and the best cut-off values for prediction were 19.5 scores,15.5 scores and 19.5 scores,respectively.The AUC area(95%confidence interval)of the Sengupta score for predicting whether severe bleeding,rebleeding,and 30-day death were 0.863,0.793,and 0.871,respectively(P<0.05),and the best cut-off values were 3.5 scores,7.5 scores,and 6.5 scores,respectively.Conclusion Oakland score and Sengupta score have certain value in predicting severe bleeding,rebleeding and 30-day death in acute lower gastrointestinal hemorrhage.The value of Oakland score in predicting severe bleeding in acute lower gastrointestinal hemorrhage is better than that of Sengupta score,but the value of the two scores in predicting rebleeding and 30-day death in acute lower gastrointestinal hemorrhage is comparable.

关 键 词：下消化道出血 预后评估 Oakland评分 Sengupta评分 

分 类 号：R57[医药卫生—消化系统]