急诊内镜及择期内镜诊疗急性非静脉曲张性上消化道出血的临床对比分析

Comparative Analysis between Emergent Endoscopy and Selective Endoscopy in Diagnosis and Treatment of Acute Non-variceal Upper Gastrointestinal Bleeding

目的探讨急诊内镜及择期内镜诊疗急性非静脉曲张性上消化道出血的临床价值。方法选取2014年5月—2015年12月收治的112例急性非静脉曲张性上消化道出血患者为研究对象,按照内镜手术时间分为急诊内镜组(入院24 h内行胃镜检查)和择期内镜组(入院>24 h内行胃镜检查),每组56例。观察并记录两组上消化道出血的病因,比较病因检出率、止血成功率、输血率、再次出血发生率、手术率以及住院时间。结果急诊内镜组病因检出率明显高于择期内镜组(P<0.05)。两组止血成功率比较无统计学意义(P>0.05)。急诊内镜组输血率、再次出血发生率、手术率、住院时间均显著低于择期内镜组(P<0.05)。结论急诊内镜诊疗急性非静脉曲张性上消化道出血操作简单、起效迅速、疗效确切且安全性高,是诊疗急性非静脉曲张性上消化道出血的首选方法。

Objective To investigate clinical value between emergent endoscopy and selective endoscopy in diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding.Methods A total of112patients with acute non-variceal upper gastrointestinal bleeding admitted between May2014and December2015were recruited in this study,and the patients were divided into emergent endoscopy group(gastroscopy within24h after admission,n=56)and selective endoscopy group(gastroscopy larger than24h after admission,n=56)according to operative times.In two groups,causes of upper gastrointestinal bleeding were observed and recorded,and positive detection rates(PDR)of causes,achievement rate of hemostasis,blood transfusion rate,rebleeding incidence rate,operative rate and length of stay were compared.Results PDR of causes in emergent endoscopy group was significantly higher than that in selective endoscopy group(P<0.05).There was no significant difference in achievement rate of hemostasis between two groups(P>0.05).In emergent endoscopy group,values of blood transfusion,rebleeding,operative rates and length of stay were significantly lower than those in selective endoscopy group(P<0.05).Conclusion Emergent endoscopy in diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding are easy operation and quickly having effectiveness with good efficacy and safety,and it can be used as the first choice in diagnosis and treatment of acute non-variceal upper gastrointestinal bleeding.