急诊内镜、择期内镜诊疗急性非静脉曲张性上消化道出血的临床效果比较

Comparison on the clinical effect of emergency endoscopy and elective endoscopy in the diagnosis and treatment of acute non-varicose upper gastrointestinal bleeding

目的探讨不同时机内镜治疗对急性非静脉曲张性上消化道出血(ANVUGIB)的治疗效果。方法100例ANVUGIB患者,根据内镜诊疗时机不同分为观察组和对照组,每组50例。观察组行急诊内镜诊疗,对照组行择期内镜诊疗。比较两组病因诊断率、再出血率、输血量、出血控制时间、住院时间及住院费用。结果观察组病因诊断率98.00%高于对照组的80.00%,术后7、30 d再出血率分别为6.00%、4.00%低于对照组的24.00%、20.00%,差异具有统计学意义(P<0.05)。观察组输血量(283.34±80.36)ml少于对照组的(484.76±120.72)ml,出血控制时间(2.02±0.13)d、住院时间(9.50±1.03)d短于对照组的(2.58±0.54)、(10.64±1.17)d,住院费用(10340.67±807.64)元低于对照组的(11658.17±1000.77)元,差异具有统计学意义(P<0.05)。结论急诊内镜诊疗ANVUGIB可尽快控制病情,有利于患者恢复,减少患者住院费用,值得推广应用。

Objective To discuss the therapeutic effect of different timing of endoscopic treatment for acute non-varicose upper gastrointestinal bleeding(ANVUGIB).Methods A total of 100 patients with ANVUGIB were divided into observation group and control group according to the different timing of endoscopic diagnosis and treatment,with 50 cases in each group.The observation group received emergency endoscopic diagnosis and treatment,while the control group received elective endoscopic diagnosis and treatment.The etiological diagnosis rate,rebleeding rate,blood transfusion volume,bleeding control time,hospitalization time and hospitalization expenses were compared between the two groups.Results In the observation group,the etiological diagnosis rate 98.00%was higher than 80.00%of the control group;the rebleeding rates at 7 and 30 d after surgery were 6.00%and 4.00%,which were lower than 24.00%and 20.00%of the control group;all the differences were statistically(P<0.05).The blood transfusion volume(283.34±80.36)ml of the observation group was less than(484.76±120.72)ml of the control group,the bleeding control time(2.02±0.13)d and the hospitalization time(9.50±1.03)d were shorter than(2.58±0.54)and(10.64±1.17)d of the control group,and the hospitalization cost(10340.67±807.64)yuan was lower than(11658.17±1000.77)yuan of the control group;all the differences were statistically significant(P<0.05).Conclusion Emergency endoscopic treatment of ANVUGIB can control the disease as soon as possible,which is conducive to recovery and reduce the hospitalization cost of patients.It is worthy of promotion and application.