急诊内镜与择期内镜对急性非静脉曲张性上消化道出血的临床价值对比

Comparison of the Clinical Value of Emergency Endoscopy and Elective Endoscopy in the Treatment of Acute Non-Varices Upper Gastrointestinal Bleeding

目的:对比急诊内镜与择期内镜对急性非静脉曲张性上消化道出血(ANVUGIB)的临床价值。方法:选择2018年5月~2019年4月169例ANVUGIB患者,按内镜诊疗时间的不同将其分为两组:急诊内镜组(n=85)与择期内镜组(n=84)。比较急诊内镜与择期内镜对ANVUGIB病因的检出率及治疗效果。结果:急诊内镜明确检出病因81例(95.3%),未能明确病因4例(4.7%),择期内镜明确检出病因73例(86.9%),未能明确病因11例(13.1%),急诊内镜对ANVUGIB病因的检出率明显高于择期内镜(P<0.05)。急诊内镜止血成功82例(96.5%),再次出血4例(4.7%),转手术1例(1.2%);择期内镜止血成功75例(89.3%),再次出血9例(10.7%),转手术5例(6.0%);急诊内镜止血成功率明显高于择期内镜(P<0.05)。结论:对于ANVUGIB应早期行急诊内镜,不仅能及时明确病因,还能有效提高止血成功率。

Objective:To compare the clinical value of emergency endoscopy and elective endoscopy for acute non-varices upper gastrointestinal bleeding(ANVUGIB).Methods:A total of 169 ANVUGIB patients from May 2018 to April 2019 were selected and divided into two groups of emergency endoscopy group(n=85)and elective endoscopy group(n=84)according to the time of endoscopic diagnosis and treatment.To compare the detection rate of ANVUGIB etiology and the treatment effect of emergency endoscopy and elective endoscopy.Results:81 cases(95.3%)of the cause were clearly detected by emergency endoscopy,4 cases(4.7%)were not clear,the cause of 73 cases(86.9%)was clearly detected by endoscopy during the elective period,and the cause of 11 cases(13.1%)was not clear,the detection rate of the cause of ANVUGIB by emergency endoscopy was significantly higher than that of elective endoscopy(P<0.05).Emergency endoscopic hemostasis was successful in 82 cases(96.5%),re-bleeding in 4 cases(4.7%),and 1 case(1.2%)transferred to surgery;75 cases(89.3%)were successful in elective endoscopic hemostasis,and 9 cases(10.7%)were re-bleeding,5 cases were transferred to surgery(6.0%);the success rate of emergency endoscopic hemostasis was significantly higher than that of elective endoscopy(P<0.05).Conclusion:Early emergency endoscopy should be performed for ANVUGIB,which can not only identify the cause in time,but also effectively improve the success rate of hemostasis.