消化性溃疡出血内镜下注射治疗后再出血的危险因素探讨

The risk factors of rebleeding following endoscopic hemostasis in patients with bleeding peptic ulcers

目的 探讨消化性溃疡出血内镜注射止血后再出血可能的危险因素。方法 对 2 3例一周内再出血及 135例无再出血患者的临床及内镜表现特征进行单因素非条件logistic回归分析 ,在此基础上进一步进行多因素的logistic回归分析。结果 单因素分析有显著意义的变量为入院时休克、血红蛋白浓度、血尿素氮浓度、内镜下喷血表现、内镜下渗血表现。多因素非条件logistic回归分析发现 ,再出血与入院时休克、内镜下喷血、内镜下渗血相关有显著性意义。结论 入院时休克。

Objective To evaluate the possible risk factors for rebleeding following endoscopic injection hemostasis in patients with bleeding peptic ulcers.Methods Multivariate logistic regression analysis of clinical and endoscopic variables were performed in 23 patients for rebleeding within one week and 135 patients with no rebleeding.Results 23 patients experienced rebleeding(13 9%),8 patients needed operations(5 1%),Five deaths occurred(3 2%).In univariate analysis,rebleeding was significantly related to shock on addmission,presence of spurting activity,presence of oozing activity.Age,sex,a history of ulcer and ulcer bleeding,concomitant disease,location and size of ulcer were not significantly related to rebleeding.In multiple logistic regression analysis,shock,presence of spurting,presence of oozing remained the significant independent risk factors for rebleeding.Conclusion The patients most likely to rebleeding were those who were shock,spurting or oozing of blood,and independent risk factors for rebleeding.