ICU重症患者并发上消化道出血的临床诊治及预后分析

Clinical Diagnosis,Treatment and Prognosis of ICU Severe Patients with Upper Gastrointestinal Bleeding

目的:分析ICU重症患者并发上消化道出血的临床诊治及预后情况。方法:将2020年8月-2021年8月北京市中关村医院收治的70例ICU重症并发上消化道出血患者视为研究对象,利用随机数字表法将患者分为研究组和参考组,每组35例。参考组采取常规方法诊治,研究组在参考组基础上采取对症支持方法诊治。通过观察两组生命体征趋于平稳的时间、上消化道停止出血时间、总出血量评估诊治效果,用住院总时长、治疗前后血红蛋白(hemoglobin,HGB)水平、急性生理与慢性健康状况评分Ⅱ(APACHE-Ⅱ)评估预后效果。结果:研究组生命体征趋于平稳时间、上消化道停止出血时间均早于参考组,总出血量低于参考组,差异均有统计学意义(P<0.05)。研究组住院总时长短于参考组(P<0.05)。治疗前,两组HGB水平、APACHE-Ⅱ评分比较,差异均无统计学意义(P>0.05);治疗后,两组HGB水平均高于治疗前,APACHE-Ⅱ均低于治疗前,且研究组均优于参照组,差异均有统计学意义(P<0.05)。结论:针对ICU重症并发上消化道出血患者,对症支持的临床诊治效果好,可在短时间内使生命体征趋于平稳,避免上消化道持续出血,从而降低死亡风险,同时改善预后,帮助患者尽快出院。

Objective:To analyze the clinical diagnosis,treatment and prognosis of ICU severe patients complicated with upper gastrointestinal bleeding.Method:A total of 70 ICU severe patients complicated with upper gastrointestinal bleeding from August 2020 to August 2021 were divided into the study group and the reference group according to the random number table method,35 cases in each group.The reference group was treated with routine methods,and the study group was treated with symptomatic support methods on the basis of the reference group.The diagnosis and treatment effects of two groups were evaluated by observing the the time for vital signs to stabilize,time for upper gastrointestinal tract to stop bleeding and total amount of bleeding,the prognosis effects were evaluated by the total length of hospital stay,hemoglobin(HGB)levels and acute physiology and chronic health evaluation scoresⅡ(APACHE-Ⅱ)of two groups before and after treatment.Result:The time for vital signs to stabilize and time for the upper gastrointestinal tract to stop bleeding in the study group were earlier than those in the reference group,and the total amount of bleeding was lower than that in the reference group,the differences were statistically significant(P<0.05).The total length of hospitalization in the study group was shorter than that in the reference group(P<0.05).Before treatment,there were no significant differences in HGB level and APACHE-Ⅱscore between two groups(P>0.05);after treatment,the HGB levels of two groups were higher than those before treatment,APACHE-Ⅱscores of two groups were lower than those before treatment,and the study group were better than those in the reference group,the differences were statistically significant(P<0.05).Conclusion:ICU severe patients complicated with upper gastrointestinal bleeding,the clinical diagnosis and treatment effect of symptomatic support is good,which can stabilize the vital signs in a short time,avoid the continuous upper gastrointestinal bleeding,reduce the risk of death,improve the prognosis,and help discharge as soon as possible.