急诊内镜检查对急性上消化道大出血的诊断价值

The value of emergency endoscopy detecting for acute hemorrhagic upper alimentary canal clinical diagnosis.

报告我院74例急诊内镜的资料。男58例,女16例。所有病人均系上消化道出血的病因不清或不能确定出血部位。检查时间在末次出血48h内58例(78.4％)。出血原因以十二指肠球部渍疡居第1位(28.4％),胃溃疡次之(21.6％〕,慢性胃炎为第3位(14.8％),胃癌与急性胃粘膜损伤同为第4位(9.5％)。各种病因在不同年龄组的分布不同。急诊内镜检查74例中,68例有阳性结果,阳性率为91.8％。表明急诊内镜检查对上消化道出血有较高的阳性率,同时也为活动性出血提供了局部止血的条件。

The report has discussed and showed the endoscopy detecting advantage is diagnosis and treatment by analysing the data of emergency endoscopy of 74 cases in People's Hospital of Gansu Province. The patient cases in the report including 16 females and 58 males were in unclear position of upper alimentary canal bleeding or bleeding not to be diagnosed accurately. 58 cases of 78. 4 per cent were examined within 48 hoars from last bleeding, and the else 16 cases of 21. 6 per cent were examined within 72 hours or more. According to analyse the cases of upper alimentary canal bleeding detected by the emergency endoscopy. The first causes (28. 4 per cent of 74 cases) is bulb ulcer of duodenum; The second (21. 6 per cent) is gastric ulcer. The third (14. 8 per cent) is chronic gastritics. But gastric cancer and acute gastric musosa lesion are the third or the fourth as well (9.5 per cent). The different distribution above the cases were determined by the different age of the patients. In 74 cases of emergency endoscopy, there were 68 cases showing positive results. The positive rate is 91. 8 per cent. The data indicated that there was high positive rate in emergency endoscopy detecting of upper alimentary canal bleed-ing. So the more exact diagnosis can be provided , mean while the hemorrhage condition of activity bleeding also can be provided by this way.