急性上消化道出血分型应用价值的探讨

The Application Value of Bleeding Types in Acute Upper Peptic Tract Hemorrhage

目的:探讨急性上消化道出血分型在急诊的应用价值。方法:对334例急性上消化道出血的患者根据出血速度、量、急诊手术的顺序分为五型:急速型、持续型、间歇型、徐缓型和急速一止血型,进行回顾性研究。结果:急速型短时出血量大,需急诊手术;持续型出血量多,持续时间长,常需连续输血;间歇型初始出血量不大,且止血3天后再次大量出血,常需输血及急诊手术治疗;徐缓型虽持续时间长,但出血量不多且逐日减少,有时需输血;急速-止血型出血较急,量较多,但一般48～72 h不再出血,有时需输血、手术。结论:对急性上消化道出血的监测除沿用传统的血液动力学指标外,出血型的分析对判断、预见病情发展及采取有效的急救治疗措施是一种简便、有价值的临床指标。

Objective:To detect the application value of bleeding types in acute upper peptic tract hemorrhage during emergency. Methods:334 cases of acute upper peptic tract hemorrhage patients were retrospectively classified into 5 types according to the velocity and output of hemorrhage and the order of emergent operation. They are successfully urgent,persistent,intermittent,slow and urgent-hemostasis types. Results:The bleeding was generous in urgent type during short time and this type repaired to be operated immediately. The persistent type was characteristic with bleeding persisted and heavily. It offend needed transfusing blood continuously. The bleeding was not abundant at the beginning but abundant bleeding appeared again 3 days after hemostasis. This type also demanded blood transfusion and emergent operation. Although the time was persist in slow type, the bleeding was not more but also decreased day by day and sometimes needed blood transfusion. The bleeding was abrupt and abundant in urgent-hemostasis type. In this type, bleeding didn't emerge between 48~72 hours and at times blood transfusion and operation were required. Conclusion:The bleeding types of upper peptic tract hemorrhage was a useful and simple clinical index to judge and predicate illness state except that traditional hymodynamics monitoring indexes and then guide doctors to take effective first aid steps.