肝硬化合并上消化道出血急诊胃镜诊疗经验

Endoscopic diagnosis and treatment of cirrhosis complicated with upper gastrointestinal bleeding

目的探讨急诊胃镜在肝硬化合并上消化道出血患者诊疗中的价值.方法回顾性分析2019年1月至2019年12月期间收治及诊断明确为肝硬化合并上消化道出血,并行急诊胃镜检查及治疗的患者的临床资料.结果本研究共纳入患者2766例次,所有患者均成功行急诊胃镜检查,其中内镜下可见出血部位的2178例次(78.74%)、未见出血部位的588例次(21.26%).明确出血部位的患者中,食管胃静脉曲张破裂出血1256例次(57.67%),其中行内镜下组织胶、硬化或套扎治疗者1183例次(1145例成功行内镜下止血、38例内镜下止血失败,均补充行三腔两囊管压迫止血后好转).结论急诊胃镜是肝硬化合并上消化道出血行之有效的治疗方法,在积极改善一般情况、病情稳定后,应尽快行急诊胃镜检查治疗,可快速明确病因、控制病情,并获得良好的疗效,应在临床上推广.

Objective To investigate the value of emergency gastroscopy in the diagnosis and treatment of patients with cirrhosis complicated with upper gastrointestinal bleeding.Methods The clinical data and endoscopic findings of patients with cirrhosis with upper gastrointestinal bleeding from January 2019 to December 2019 were retrospectively analyzed.Results A total of 2766 patients were enrolled in the study.No bleeding site was observed in 588 cases.Among the rest 2178 cases,1256 cases were diagnosed with EGVB(57.67%),and 1183 cases were treated with sclerosis,ligation and tissue adhesive embolization,and effective rate was 96.79%(1145/1183).Conclusion Emergency gastroscopy is an effective treatment for cirrhosis with upper gastrointestinal bleeding.After actively improving the general condition and the condition is stable,emergency gastroscopy should be performed as soon as possible,which can quickly clarify the cause and control the bleeding,and obtain good efficacy,which should be promoted in clinical practice.