Blatchford评分对预测消化性溃疡出血患者选择内镜下治疗的初步研究

The Study of the Blatchford score with the need of endoscopic treatment in patients with peptic ulcer bleeding

目的比较Blatchford和内镜前Rockall评分对消化性溃疡出血患者是否需要胃镜下治疗的预测价值。方法选取2009年1月至2012年7月在我院住院治疗的382例确诊为消化性溃疡出血患者,入院后给予药物治疗及内镜下治疗,并统计Blatchford和内镜前Rockall评分。结果 382例消化道溃疡出血患者中,120例(31.4%)需要进行内镜下治疗。按照Blatchford评分系统,中高危组需要进行内镜下治疗率明显高于低危组,差异具有统计学意义。需要内镜下治疗患者的Blatchford评分(9.6±4.2)要显著高于不需要治疗的患者(6.5±3.5)(P<0.05)。而按照内镜前Rockall评分系统,无法通过评分来明确区分是否需要进行内镜下治疗。结论 Blatchford评分能更准确的判断患者是否需要内镜下治疗,特别是评分为0是不需要进行内镜下治疗。而Rockall评分不能用来对低风险进行判断。

Objective To investigate the predictive value of the Blatchford and pre-endoscopic Rockall score with the need of endoscopic treatment in patients with peptic ulcer bleeding.Methods 382 patients with hemorrhagic peptic ulcer were observed between Jan.2009 and Jul.2012 in Zhangzhou Affiliated Hospital.All patients had drug treatment and endoscopic examination,Blatchford and pre-endoscopic Rockall scores were prospectively calculated for all patients,and the need for endoscopic treatment was determined during the endoscopy.Results In 382 cases,120 cases（31.4%） needed to endoscopic treatment.According to the Blatchford score,the high-risk group of the need for endoscopic treatment was obviously higher than that of the low-risk group（P0.05）.The mean Blatchford score for those who needed therapeutic endoscopy was significantly higher（P0.05）.But the Pre-rockall score was unable to predict this need.Conclusion Blatchford score could be more accurate judgment whether patients needed endoscopic treatment,especially for the score of 0.The Rockall score was unable to low risk judgment.