上消化道急性应激性黏膜病变出血的内镜诊断和治疗

目的观察内镜诊断治疗上消化道急性应激性黏膜病变出血的效果，积累临床经验。方法：对本院接诊收治的上消化道急性应激性黏膜病变出血患者的临床资料进行回顾性分析，并且对50例患者进行内镜诊断，实施常规治疗＋内镜下治疗，归纳、总结诊断结果以及治疗效果。结果：经内镜诊断，发现上消化道急性应激性黏膜病变出血的表现形式主要有四种，即：充血水肿型，急性溃疡型，出血糜烂型，坏死剥脱型；临床治疗同样有4种主要方式，即：单纯的实施内镜下止血（全部止血成功）、实施内镜下止血＋静脉给药止血（全部止血成功）、实施内镜下止血＋静脉给药止血＋胃管注药、实施内镜下止血＋静脉给药＋胃管注药十手术止血。结论：对上消化道急性应激性黏膜病变出血患者实施内经诊断，能够提升诊断准确率，且根据诊断结果，针对性的给予患者最佳的临床治疗，能够改善患者的生活质量。

Objective our hospital since November 2014 - November 2015 accepts admitted during the period of 50 cases ofupper gastrointestinal bleeding in patients with acute stress mucosal lesions of clinical data were analyzed retrospectively, andwere 50 cases of patients with endoscopic diagnosis, implementation of routine therapy ＋ endoscopic treatment, conclude andsummarize the diagnosis and treatment effect.Resuhs： endoscopic diagnosis and found the acute stress of upper gastrointestinaltract hemorrhage from mucosal lesions form mainly has four kinds, namely： belongs to the hyperemia oedema 21 cases ofpatients, belonging to 13 eases of patients with acute ulcer type, belongs to the patients with hemorrhage type is a type of 9cases, belong to necrosis in patients with type stripped of 7 cases; Clinical treatment as there are four main ways, namely： theimplementation of the 8 cases of pure endoscopic hemostatic （all hemostatic success）, 15 cases of endoscopic hemostatic ＋intravenous dosing bleeding （all hemostatic success）, 23 cases endoscopic hemostatic ＋ ＋ stomach tube injection intravenousdosing hemostatic medicine （19 patients stop bleeding success, failure） in 4 patients, 4 cases of endoscopic hemostatic ＋ ＋stomach tube injection intravenous drug medicine ＋ surgical hemostasis （bleeding, 2 cases with 2 patients failed）.Conclusion：the upper gastrointestinal bleeding in patients with acute stress mueosal lesions implement Canon of diagnosis, can improvediagnostic accuracy, and according to the result of diagnosis, targeted to give patients the best clinical treatment, can improvethe patient＇s quality of life.