CAJ | 학술논문

目的：探讨Rockall与Blatchford评分系统在上消化道出血的诊治价值。方法选择2013年10月—2014年6月该院消化科的急性上消化道出血患者122例，分别采用Rockall和Blatchford两种评分系统对病人进行分值计算和危险分层，计算不同危险分层下的再出血率和死亡率，运用受试者特征曲线下面积(AUC)检验并比较Rockall和Blatchford评分系统对再出血和死亡的预测能力。结果 Rockall评分系统下，高危组再出血率和死亡率显著高于中低危组（P＜0.05），中危组再出血率和死亡率显著高于低危组（P＜0.05）；Blatchford评分系统下，中高危组的再出血率和死亡率显著高于低危组（P＜0.05）。死亡组的Rockall评分显著高于生存组（P＜0.05）；死亡组的Blatchford评分与生存组相比差异无统计学意义（P＞0.05）；再出血组的Rockall和Blatchford评分分别与未再出血组相比差异无统计学意义（P＞0.05）；Rockall评分系统评估死亡率和再出血率AUC分别为0.742、0.675，Blatchford评分系统评估死亡率和再出血率AUC分别为0.595、0.734。结论 Rockall与Blatchford评分系统能够作为上消化道出血诊治预判的方法，能够准确预测再出血、死亡。
목적：탐토Rockall여Blatchford평분계통재상소화도출혈적진치개치。방법선택2013년10월—2014년6월해원소화과적급성상소화도출혈환자122례，분별채용Rockall화Blatchford량충평분계통대병인진행분치계산화위험분층，계산불동위험분층하적재출혈솔화사망솔，운용수시자특정곡선하면적(AUC)검험병비교Rockall화Blatchford평분계통대재출혈화사망적예측능력。결과 Rockall평분계통하，고위조재출혈솔화사망솔현저고우중저위조（P＜0.05），중위조재출혈솔화사망솔현저고우저위조（P＜0.05）；Blatchford평분계통하，중고위조적재출혈솔화사망솔현저고우저위조（P＜0.05）。사망조적Rockall평분현저고우생존조（P＜0.05）；사망조적Blatchford평분여생존조상비차이무통계학의의（P＞0.05）；재출혈조적Rockall화Blatchford평분분별여미재출혈조상비차이무통계학의의（P＞0.05）；Rockall평분계통평고사망솔화재출혈솔AUC분별위0.742、0.675，Blatchford평분계통평고사망솔화재출혈솔AUC분별위0.595、0.734。결론 Rockall여Blatchford평분계통능구작위상소화도출혈진치예판적방법，능구준학예측재출혈、사망。
Objective To investigate the value of Rockall and Blatchford risk scoring systems in the diagnosis and treatme upper gastrointestinal bleeding. Methods 122 cases with acute upper gastrointestinal bleeding admitted in the Gastroenterology Depart-ment of our hospital between October 2013 and June 2014 were selected, respectively using Rockall and Blatchford risk scoring system scored and grouped the patients by risk scores. The rebleeding and mortality and other prognosis were observed in the fol-low-up patients in 2 months, and the rates of rebleeding and mortality of the groups with different risk scores were calculated. The area under the receiver operating characteristic curve (AUC) was calculated to verify the efficiency of these two risk scoring sys-tems. Results According to Rockall risk scoring, rates of rebleeding and mortality in high risk group were much higher than those in intermediate risk group and low risk group (P<0.05), and those in intermediate risk group were much higher than those in low risk group (P<0.05). According to Blatchford risk scoring, rates of rebleeding and mortality in high-intermediate risk group were much higher than those in low risk group (P<0.05). In death group, Rockall score was significantly higher than the survival group (P<0.05); there was no statistically significant difference between death group and survival group according to Blatchford risk scor-ing(P>0.05); there was no statistically significant difference between rebleeding group and non-rebleeding group according to two risk scoring systems(P>0.05);The AUC of Rockall scoring system to assess mortality and rate of rebleeding were 0.742, 0.675, the AUC of Blatchford scoring system were 0.595, 0.734. Conclusion Both Rockall and Blatchford risk scoring systems can be used to indicate the risk and assess the prognosis of upper gastrointestinal bleeding, and have good accuracy on predicting rebleeding and mortality.