急诊内镜在消化道肿瘤患者上消化道出血中的诊疗价值

Diagnosis and treatment value of emergency endoscopy in upper gastrointestinal hemorrhage patients with gastrointestinal cancer

目的探讨急诊内镜在消化道肿瘤患者上消化道出血中的诊疗价值。方法选择2012年6月至2014年5月间收治的115例消化道肿瘤致上消化道出血患者作为研究对象,A组(40例)患者在出血24 h内行急诊内镜检查并进行止血治疗,B组(40例)患者在出血24 h后行内镜检查并进行止血治疗,C组(35例)患者行内科保守治疗,回顾性分析其临床资料,比较3组患者的诊疗情况。结果 A组患者的病因检出率、止血成功率明显高于B组和C组,而3个月复发率明显低于B组和C组,组间差异有统计学意义(P<0.05)。A组患者的止血时间明显短于B组和C组,差异有统计学意义(P<0.05)。A组、B组、C组的不良反应发生率差异有统计学意义(P>0.05)。随访3个月,A组患者的诺丁汉健康调查问卷(NHP)评分明显优于B组和C组,差异有统计学意义(P<0.05)。结论急诊内镜应用于消化道肿瘤患者上消化道出血能够获得更高的病因检出率和止血成功率,并且可缩短止血时间,降低复发率,显著改善患者的生活质量,具有重要的诊疗价值。

Objective To investigate the diagnosis and treatment value of emergency endoscopy in upper gastrointestinal hemorrhage patients with gastrointestinal cancer. Methods From June 2012 to May2014 in Yichang Central People＇s Hospital,115 gastrointestinal cancer cases with upper gastrointestinal hemorrhage were selected in the study and their clinical data were analyzed retrospectively. 40 cases of group A were treated by emergency endoscopy within 24 h bleeding; 40 cases of group B were underwent endoscopy after 24 h bleeding; 35 cases of group C were treated by routine conservative treatment. The diagnosis and treatment situation of three groups were compared. Results The etiology detection rate and hemostasis success rate of group A were significantly higher than those of group B and C,while the recurrence rate in 3-month was significantly lower than thant of group B and C,with significant differences（ P〈0. 05）; the bleeding time of group A was significantly shorter than that of group B and C,with significant difference（ P〈0. 05）; the adverse reaction rate of group A,B and C were compared,and there was no significant difference（ P〉0. 05）; followed up for 3 months,the Nottingham health Survey group A（ NHP）score of group A was significantly better than that of group B and C,and there was significant difference（ P〈0. 05）. Conclusions Emergency endoscopy in upper gastrointestinal hemorrhage patients with gastrointestinal cancer can cause a higher etiology detection rate and hemostasis success rate,shorten bleeding time,reduce the relapse rate,and significantly improve the quality life of patients,so it has significant diagnosis and treatment value.