消化内镜治疗非静脉曲张性上消化道出血后再出血的危险因素临床分析

Clinical Analysis of Risk Factors for Rebleeding after Gastrointestinal Endoscopy in the Treatment of Non-varices Upper Gastrointestinal Bleeding

目的分析探究非静脉曲张性上消化道出血治疗期间应用消化内镜发生再出血的危险因素。方法方便选取2019年12月—2020年12月该院确诊的112例非静脉曲张性上消化道出血患者作为研究对象,均接受消化内镜治疗,治疗后发生再出血的患者共计40例,纳入观察组,未出血者共计72例,纳入对照组,对比两组患者病因、实验室指标以及入院情况,选取应用多因素Logistic分析评估非静脉曲张性上消化道出血患者接受消化内镜治疗后再出血的危险性因素。结果两组患者出血量分别为(252.63±17.86)、(122.79±13.44)mL,血红蛋白分别为(85.57±8.52)、(110.48±9.63)g/L,血小板分别为(100.96±10.22)、(148.43±13.78)×109/L,血尿素氮分别为(19.48±4.22)、(10.74±3.42)mmol/L,两组对比差异有统计学意义(t=43.444、13.653、19.054、11.903,P<0.05);观察组的单因素分析结果包含出血量、休克发生率、血尿素氮、内镜下活动性出血、血红蛋白以及血小板,所得数值对比差异有统计学意义(P<0.05),且多因素Logistic分析结果可见出血量、血小板、血红蛋白、血尿素氮、活动性出血、休克为非静脉曲张性上消化道出血应用消化内镜治疗后再出血的独立危险因素(P<0.05)。结论非静脉曲张性上消化道出血患者在消化内镜治疗期间发生再出血的危险因素比较复杂,包含出血量、血小板、血红蛋白、血尿素氮、活动性出血、休克等,还需采取针对性的预防措施,有效预防再出血事件发生。

Objective To analyze and explore the risk factors of rebleeding during the treatment of non-varices upper gastrointestinal bleeding using digestive endoscopy.Methods A total of 112 patients with non-varices upper gastrointestinal bleeding diagnosed in the hospital from December 2019 to December 2020 were convenient selected as the research object.All received digestive endoscopy treatment.A total of 40 patients who had re-bleeding after treatment were included in the observation group;a total of 72 patients without bleeding were included in the control group.The etiology,laboratory indicators and admission status of the two groups of patients were compared,and multivariate Logistic analysis was selected to evaluate the risk factors for rebleeding after gastrointestinal endoscopy in patients with non-varices upper gastrointestinal bleeding.Results The amount of blood loss in both groups were(252.63±17.86)mL,(122.79±13.44)mL,hemoglobin(85.57±8.52)g/L,(110.48±9.63)g/L,platelets(100.96±10.22)×109/L,(148.43±13.78)×109/L,blood urea nitrogen(19.48±4.22)mmol/L,(10.74±3.42)mmol/L,the difference was statistically significant(t=43.444,13.653,19.054,11.903,P<0.05).The univariate analysis results of rebleeding included bleeding volume,incidence of shock,blood urea nitrogen,active bleeding under endoscopy,hemoglobin and platelets,compatison of obtained values,the difference was statistically significant(P<0.05).And multivariate Logistic analysis showed that bleeding volume,platelets,hemoglobin,blood urea nitrogen,active bleeding,and shock were independent risk factors for rebleeding after treatment used digestive endoscopy in the non-varices upper gastrointestinal bleeding(P<0.05).Conclusion The risk factors for rebleeding in patients with non-varices upper gastrointestinal bleeding during gastrointestinal endoscopic treatment are more complicated,including blood loss,platelets,hemoglobin,blood urea nitrogen,active bleeding,shock,etc.It is also necessary to take targeted preventive measures to effectively prevent the occurrence of rebleeding incidents.