非静脉曲张性上消化道出血内镜治疗成功后再出血的危险因素分析

Risk Factors of Rebleeding after Endoscopic Treatment for Non-variceal Upper Gastrointestinal Bleeding

目的对非静脉曲张性上消化道出血内镜治疗成功后再出血的危险因素及措施进行研究。方法选取该院2014年10月—2016年10月收治的350例非静脉曲张性上消化道出血患者,对其进行首次内镜治疗并成功止血。根据患者再出血情况将其分为对照组和研究组。对照组为再出血患者,研究组为未出血患者,对比分析两组患者的临床资料以及再出血原因。结果研究显示,对照组患者的血尿素氮水平(235±101)mmol/L以及病变类型等方面与研究组患者之间差异无统计学意义(P>0.05)。对比两组患者入院时休克、治疗时间、血小板指数、血红蛋白指数、Ⅰa级出血病变直径、单一内镜治疗、恶性中流出血、支持治疗不足以及后续质子泵抑制剂不足等方面,研究组患者的血小板指数为(118.43±42.64)×109/L,血红蛋白为(88.48±6.41)g/L,对照组患者的血小板指数为(106.20±41.62)×109/L,血红蛋白为(85.85±6.18)g/L,两组差异有统计学意义(P<0.05),并且以上指数也是导致非静脉曲张性上消化道出血患者再出血的危险因素。结论导致非静脉曲张性上消化道出血患者止血成功后再出血的危险因素在于院时休克、治疗时间、血小板指数、血红蛋白指数、Ⅰa级出血病变直径、单一内镜治疗、恶性肿瘤出血、支持治疗不足以及后续质子泵抑制剂不足。

Objective This paper tries to study the risk factors and measures of non-variceal upper gastrointestinal rebleeding after successful endoscopic treatment of bleeding.Methods 350 cases with gastrointestinal bleeding of non-varicose veins in this hospital from October 2014 to October 2016 were selected and hemostasis on the upper gastrointestinal endoscopic therapy for the first time was carried out.According to the rebleeding situation of patients,they were divided into the control group and the study group.The patients in the control group were with recurrent bleeding,the study group without bleeding,and the comparative analysis of the clinical data of two patients and the cause of hemorrhage were implemented.Results As the study showed,the blood urea nitrogen level was(235±101)mmol/L and lesion types in the control group were not significantly different from those in the study group(P>0.05).Compared two groups of patients with shock on admission,treatment time,hemoglobin,platelet index,index of a bleeding lesion diameter and single endoscopic treatment,malignant hemorrhage,inadequate support treatment and in subsequent deficiency of proton pump inhibitors,the platelet index in the study group was(118.43±42.64)×109/L,hemoglobin of(88.48±6.41)g/L,and those of the study group were(106.20±41.62)×109/L,hemoglobin of(85.85±6.18)g/L,with significant difference between the two groups(P<0.05),and the above index were the main risk factors in patients with recurrent bleeding of non-variceal upper gastrointestinal tract.Conclusion The causes of rebleeding risk factors of patients with digestive tract hemorrhage after successful hemostasis non-variceal upper include the hospital shock,treatment time,platelet index,hemoglobin index,Ⅰa-degree bleeding lesion diameter,single endoscopic treatment for malignant tumor,hemorrhage,inadequate support treatment and follow-up of proton pump inhibitors.