• 非静脉曲张性上消化道出血行急诊内镜止血患者病情严重且预后较差
  • Patients with nonvariceal upper gastrointestinal bleeding who received emergency endoscopic hemostasis had severe condition and poor prognosis
  • 官佳轮.非静脉曲张性上消化道出血行急诊内镜止血患者病情严重且预后较差[J].内科急危重症杂志,2022,28(1):20-23
    DOI:10.11768/nkjwzzzz20220104
    中文关键词:  非静脉曲张性上消化道出血  急诊内镜  择期内镜  止血
    英文关键词:
    基金项目:国家自然科学基金青年项目
    作者单位E-mail
    官佳轮 华中科技大学同济医学院附属同济医院消化内科 pyli@tjh.tjmu.edu.cn 
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    中文摘要:
          目的:比较分析非静脉曲张性上消化道出血(NVUGIB)床边急诊内镜与择期内镜治疗的临床特点和疗效。方法:回顾性收集304例NVUGIB并接受内镜止血治疗患者的病例资料,其中接受床边急诊内镜的152例患者纳入急诊内镜组,接受择期内镜止血的152例患者纳入择期内镜组,比较分析2组患者的一般情况、病情严重程度、疗效等。结果:2组患者的一般情况、病因构成、止血方式无明显差异(P均>0.05),与择期内镜组比较,急诊内镜组患者血红蛋白量和血小板计数低,凝血时间延长,AIMS65评分及内镜前Rockall(pRS)评分较高(P均<0.01),输血率高(60.4% vs 47.4%,P<0.01),输血量多(P<0.01),再出血率高(12.2% vs 3.9%,P<0.01),住院时间更长(P<0.01)。2组患者止血成功率都在80%以上,并发症发生率和死亡率无明显统计学差异(P>0.05)。结论:对于NVUGIB患者,需行床边急诊内镜止血者失血情况严重,凝血功能差,其输血量、再出血率、住院时间均较高或较长,但死亡率与择期内镜止血治疗者相近。
    英文摘要:
          Objective: To compare and analyze the clinical characteristics and therapeutic effects of bedside emergency endoscopy and elective endoscopy in the treatment of nonvariceal upper gastrointestinal bleeding (NVUGIB). Method: We retrospectively collected the medical records of 304 patients with NVUGIB continuously. Among them, 152 patients who underwent bedside endoscopic hemostasis after admission served as the emergency endoscopy group, and the rest who received elective endoscopic hemostasis served as the elective endoscopy group. The baseline characteristics of patients, severity of illness, and treatment effects of the two groups were analyzed and compared. Results: There was no significant difference between the emergency endoscopy group and the elective endoscopy group in the general condition, etiological components and the way of hemostasis (P>0.05). Patients in the emergency endoscopy group had lower hemoglobin and platelet count, longer prothrombin time, higher AIMS65 score and pRS score (P<0.01). In the emergency endoscopy group, the rates of blood transfusion (60.4% vs 47.4%, P<0.01), and re bleeding (12.2% vs 3.9%, P<0.01) were higher, the blood transfusion volume was larger (P<0.01), and the length of hospital stay was longer (10 days vs 8 days, P<0.01) than in the elective endoscopy group. The efficiency of hemostasis in both groups could attain more than 80%, and there was no significant difference in mortality and safety between the two groups (P>0.05). Conclusion: For patients with NVUGIB, the patients given bedside emergency endoscopic hemostasis had severe blood loss, poor coagulation function, as well as larger blood transfusion volume, higher rebleeding rate and longer length of hospital stay, but the mortality rate was similar to that of patients receiving elective endoscopic hemostasis.