中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
13期
27-29
,共3页
上消化道出血%内镜%再出血%危险因素
上消化道齣血%內鏡%再齣血%危險因素
상소화도출혈%내경%재출혈%위험인소
Upper gastrointestinal tract hemorrhage%Endoscopic%Rebleeding%Risk factors
目的：探讨消化内镜治疗上消化道出血后再出血危险因素。方法：选取本院收治的300例经消化内镜治疗止血成功的上消化道出血患者作为研究对象，根据患者的再出血情况，分为A组（再出血，n=76）和B组（未出血，n=224），对两组患者临床资料进行对比分析。结果：两组在上消化道出血史、性别、年龄、血小板、血红蛋白、血尿素氮方面比较差异均无统计学意义（P>0.05）；A组在单一内镜治疗、入院时休克、HGB<90 g/L、Ⅰa级出血、支持治疗缺乏、后续PPIs缺乏、恶性肿瘤出血方面，与B组比较差异均有统计学意义（P<0.05）；单一内镜治疗、HGB<90 g/L、Ⅰa级出血、支持治疗缺乏、后续PPIs缺乏、恶性肿瘤出血均是上消化道出血止血后再出血的危险因素（P<0.05）。结论：消化内镜治疗上消化道出血后再出血的危险因素包括支持治疗不足、喷射样出血、血色素水平低、缺少后续PPIs、恶性肿瘤出血，临床上应当密切观察、加强防护，早期实施手术治疗，以免病情加重。
目的：探討消化內鏡治療上消化道齣血後再齣血危險因素。方法：選取本院收治的300例經消化內鏡治療止血成功的上消化道齣血患者作為研究對象，根據患者的再齣血情況，分為A組（再齣血，n=76）和B組（未齣血，n=224），對兩組患者臨床資料進行對比分析。結果：兩組在上消化道齣血史、性彆、年齡、血小闆、血紅蛋白、血尿素氮方麵比較差異均無統計學意義（P>0.05）；A組在單一內鏡治療、入院時休剋、HGB<90 g/L、Ⅰa級齣血、支持治療缺乏、後續PPIs缺乏、噁性腫瘤齣血方麵，與B組比較差異均有統計學意義（P<0.05）；單一內鏡治療、HGB<90 g/L、Ⅰa級齣血、支持治療缺乏、後續PPIs缺乏、噁性腫瘤齣血均是上消化道齣血止血後再齣血的危險因素（P<0.05）。結論：消化內鏡治療上消化道齣血後再齣血的危險因素包括支持治療不足、噴射樣齣血、血色素水平低、缺少後續PPIs、噁性腫瘤齣血，臨床上應噹密切觀察、加彊防護，早期實施手術治療，以免病情加重。
목적：탐토소화내경치료상소화도출혈후재출혈위험인소。방법：선취본원수치적300례경소화내경치료지혈성공적상소화도출혈환자작위연구대상，근거환자적재출혈정황，분위A조（재출혈，n=76）화B조（미출혈，n=224），대량조환자림상자료진행대비분석。결과：량조재상소화도출혈사、성별、년령、혈소판、혈홍단백、혈뇨소담방면비교차이균무통계학의의（P>0.05）；A조재단일내경치료、입원시휴극、HGB<90 g/L、Ⅰa급출혈、지지치료결핍、후속PPIs결핍、악성종류출혈방면，여B조비교차이균유통계학의의（P<0.05）；단일내경치료、HGB<90 g/L、Ⅰa급출혈、지지치료결핍、후속PPIs결핍、악성종류출혈균시상소화도출혈지혈후재출혈적위험인소（P<0.05）。결론：소화내경치료상소화도출혈후재출혈적위험인소포괄지지치료불족、분사양출혈、혈색소수평저、결소후속PPIs、악성종류출혈，림상상응당밀절관찰、가강방호，조기실시수술치료，이면병정가중。
Objective:To investigate the risk factors of digestive endoscopy in the treatment of rebleeding of upper gastrointestinal tract hemorrhage.Method:300 patients with upper gastrointestinal hemorrhage who were stopped bleeding successfully by digestive endoscopy treatment in our hospital were selected as research objects,according to the rebleeding of patients,they were randomly divided into the group A(rebleeding group)for 76 cases and the group B(non bleeding group) for 224 cases,the clinical data of the two groups were compared and analyzed.Result: There were no significant differences in the history of upper gastrointestinal bleeding,gender,age,platelet,hemoglobin,blood urea nitrogen between the two groups(P>0.05).Single endoscopic therapy,shock on admission,HGB<90 g/L,class Ia hemorrhage, the lack of support treatment,follow-up PPIs deficiency,malignant tumor hemorrhage in the group A were significantly better than those in the group B,the differences were statistically significant(P<0.05). Single endoscopic therapy, shock on admission,HGB<90 g/L,class Ia hemorrhage,the lack of support treatment,follow-up PPIs deficiency, malignant tumor hemorrhage were the risk factors of hemorrhage of upper gastrointestinal tract bleeding after bleeding (P<0.05).Conclusion:The risk factors of digestive endoscopy in the treatment of rebleeding of upper gastrointestinal tract hemorrhage include inadequate support treatment,jet-like bleeding,low level of hemoglobin,the lack of follow-up PPIs,malignant tumor hemorrhage.In clinical practice we should be closely observed,strengthen protection,implement operation treatment in the early,in order to avoid aggravation condition.
