急性胃出血患者的急诊治疗及症状转归分析

Emergency Treatment and Symptom Outcome Analysis of Patients with Acute Gastric Hemorrhage

目的探讨急诊内镜手术治疗急性胃出血患者的临床疗效及症状转归情况。方法选择2018年1月~2019年1月我院收治的108例急性胃出血患者,两组患者均行内镜手术治疗,按手术时机分为对照组和观察组,每组54例。对照组择期手术,观察组行急诊手术治疗,比较两组临床疗效、症状缓解时间、住院时间和止血时间等指标。结果观察组治疗总有效率为94.44%,高于对照组的77.78%,差异有统计学意义(P<0.05);观察组恶心、呕血、便血及腹部灼烧感改善时间分别为[(2.45±0.34)d、(1.98±0.37)d、(2.26±0.44)d、(1.65±0.88)d],较对照组的[(4.56±0.54)d、(3.98±0.61)d、(3.19±0.56)d、(2.98±0.14)d]缩短,差异具有统计学意义(P<0.05);观察组治疗后止血时间为(2.76±0.61)d、住院时间为(6.63±1.20)d,短于对照组的(4.97±1.54)d、(8.65±2.55)d,差异具有统计学意义(P<0.05)。结论急性胃出血患者应用急诊手术治疗效果优于择期手术治疗,能有效、迅速控制出血,缓解疾病症状,提高临床疗效。

Objective To investigate the clinical efficacy and symptomatic outcome of emergency endoscopic surgery for patients with acute gastric hemorrhage.Methods 108 patients with acute gastric hemorrhage admitted to our hospital from January 2018 to January 2019 were enrolled.Endoscopic surgery was performed in both groups.The operation time was divided into control group and observation group,with 54 cases in each group.The control group underwent elective surgery,and the observation group underwent emergency surgery.The clinical efficacy,time to symptom relief,hospitalization time and hemostasis time were compared between the two groups.Results The total effective rate of the observation group was 94.44%,which was higher than that of the control group 77.78%,the difference was statistically significant(P<0.05).The improvement time of nausea,hematemesis,blood in the stool and abdominal burning was observed in the observation group[(2.45±0.34)d,(1.98±0.37)d,(2.26±0.44)d,(1.65±0.88)d],compared with the control group[(4.56±0.54)d,(3.98±0.61)d,(3.19±0.56)d,(2.98±0.14)d]shortened,the difference was statistically significant(P<0.05);the observation group had a hemostasis time of(2.76±0.61)d and a hospital stay of(6.63±1.20)d,they were all shorter than the control group(4.97±1.54)d and(8.65±2.55)d,the difference was statistically significant(P<0.05).Conclusion The application of emergency surgery in patients with acute gastric hemorrhage is better than elective surgery,which can effectively and quickly control bleeding,alleviate disease symptoms and improve clinical efficacy.