以多学科协作为导向的重症上消化道大出血的急诊综合治疗

Multidisciplinary treatment of severe upper gastrointestinal bleeding in emergency

目的:探讨多学科协作诊疗(MDT)模式在急诊上消化道大出血诊治中的应用。方法:回顾性分析2015-01-01—2016-12-31期间于我院急诊监护室(EICU)接受MDT模式治疗的上消化道大出血患者104例,对该群患者的病例特点、预后情况等进行分析。结果:本次研究中上消化道出血最常见的病因为食管胃底静脉曲张破裂(35.58%)及消化性溃疡(34.62%),采用MDT策略后,79.17%的患者在入院24h内完成内镜检查(治疗),最终92例(88.46%)患者治愈出院,平均住院时间(12.93±8.34)d。结论:MDT策略的实施可提高上消化道大出血患者的诊疗效率,降低患者死亡风险。

Objective:To explore the application of multidisciplinary treatment(MDT)mode in the diagnosis and treatment of severe upper gastrointestinal bleeding.Method:A retrospective analysis of 104 patients with severe upper gastrointestinal bleeding who accepted MDT mode in our Emergency Intensive Care Unit(EICU)from January 1,2015 to December 31,2016 was conducted.The patient’s characteristics and prognosis were analyzed.Result:The most common causes of severe upper gastrointestinal bleeding in this study were rupture of esophageal/gastric varies(35.58%)and peptic ulcer(34.62%).After the application of MDT mode,79.17% of patients completed the endoscopic examination or treatment in 24 hours.Eventually,92patients(88.46%)were cured and discharged.The average days of hospitalization were(12.93 ± 8.34)days.Conclusion:The implementation of MDT mode can improve the efficacy of the diagnosis and treatment of severe upper gastrointestinal bleeding patients and reduce the risk of mortality.