目的:探讨急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)Rockall评分高危患者行急诊内镜的诊疗价值.方法:对2011-08/2013-12山西煤炭中心医院消化内科55例ANVUGIB Rockall评分高危患者的...目的:探讨急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)Rockall评分高危患者行急诊内镜的诊疗价值.方法:对2011-08/2013-12山西煤炭中心医院消化内科55例ANVUGIB Rockall评分高危患者的临床资料、治疗方法及治疗结果作回顾性分析研究,其中出血后24-48 h内行急诊内镜检查患者30例,出血后3-5 d行内镜检查患者25例,比较行急诊内镜组与非急诊内镜组的病因检出率、住院花费、住院时间、输血量、死亡率等指标.结果:急诊内镜组与非急诊内镜组的出血病因构成差异无统计学意义(P>0.05);急诊内镜组病因确诊率高于非急诊内镜组(93.33%vs 56.00%)(P=0.001<0.01);急诊内镜组住院时间和住院费用及输血量显著低于非急诊内镜组(10.0 d±6.7 d vs 16.4 d±7.3 d,13034.4元±9967.2元vs 14110.2元±9780.8元,1180.7 m L±634.7 m L vs 1420 m L±725.9 m L)(P<0.05);急诊内镜组死亡率低于非急诊内镜组(6.67%vs 12.00%)(P>0.05).结论:对于ANVUGIB Rockall评分高危患者,行急诊内镜检查虽不能明显降低其死亡率,但可以显著改善其医疗过程,有利于临床,其优势尚待大样本的临床研究.展开更多
Background:The Rockall scoring system was developed in unselected patients,the majority of whom did not receive endoscopic therapy.The aim of this study was to assess the validity of the Rockall system in high-risk pa...Background:The Rockall scoring system was developed in unselected patients,the majority of whom did not receive endoscopic therapy.The aim of this study was to assess the validity of the Rockall system in high-risk patients who undergo endoscopic therapy for peptic ulcer hemorrhage.Methods:Rockall scores were calculated in 247 patients with major peptic ulcer bleeding entered into a randomized trial of endoscopic therapy.The observed rates of recurrent bleeding and mortality after endoscopic therapy were compared with predicted rates derived from Rockall’s study group.The validity of the Rockall system was assessed in terms of calibration and discrimination.Results:Rates of recurrent bleeding and mortality after endoscopic therapy increased with an increasing Rockall score.Observed rates of recurrent bleeding and mortality were below predicted rates,and calibration of the Rockall system was poor(Mantel-Haenszel chi square = 25.8,p < 0.0001 for recurrent bleeding;Mantel-Haenszel chi square = 15.1,p < 0.0001 for death).For the prediction of recurrent bleeding,the area under the receiver operating characteristic curve was low(63.4%),but the system was satisfactory when predicting mortality(area under the resulting curve,84.3%).Conclusions:After endoscopic therapy for a bleeding peptic ulcer,the Rockall scoring system can identify patients at high risk of death,but it is inadequate for the prediction of recurrent bleeding.展开更多
文摘目的:探讨急性非静脉曲张性上消化道出血(acute nonvariceal upper gastrointestinal bleeding,ANVUGIB)Rockall评分高危患者行急诊内镜的诊疗价值.方法:对2011-08/2013-12山西煤炭中心医院消化内科55例ANVUGIB Rockall评分高危患者的临床资料、治疗方法及治疗结果作回顾性分析研究,其中出血后24-48 h内行急诊内镜检查患者30例,出血后3-5 d行内镜检查患者25例,比较行急诊内镜组与非急诊内镜组的病因检出率、住院花费、住院时间、输血量、死亡率等指标.结果:急诊内镜组与非急诊内镜组的出血病因构成差异无统计学意义(P>0.05);急诊内镜组病因确诊率高于非急诊内镜组(93.33%vs 56.00%)(P=0.001<0.01);急诊内镜组住院时间和住院费用及输血量显著低于非急诊内镜组(10.0 d±6.7 d vs 16.4 d±7.3 d,13034.4元±9967.2元vs 14110.2元±9780.8元,1180.7 m L±634.7 m L vs 1420 m L±725.9 m L)(P<0.05);急诊内镜组死亡率低于非急诊内镜组(6.67%vs 12.00%)(P>0.05).结论:对于ANVUGIB Rockall评分高危患者,行急诊内镜检查虽不能明显降低其死亡率,但可以显著改善其医疗过程,有利于临床,其优势尚待大样本的临床研究.
文摘Background:The Rockall scoring system was developed in unselected patients,the majority of whom did not receive endoscopic therapy.The aim of this study was to assess the validity of the Rockall system in high-risk patients who undergo endoscopic therapy for peptic ulcer hemorrhage.Methods:Rockall scores were calculated in 247 patients with major peptic ulcer bleeding entered into a randomized trial of endoscopic therapy.The observed rates of recurrent bleeding and mortality after endoscopic therapy were compared with predicted rates derived from Rockall’s study group.The validity of the Rockall system was assessed in terms of calibration and discrimination.Results:Rates of recurrent bleeding and mortality after endoscopic therapy increased with an increasing Rockall score.Observed rates of recurrent bleeding and mortality were below predicted rates,and calibration of the Rockall system was poor(Mantel-Haenszel chi square = 25.8,p < 0.0001 for recurrent bleeding;Mantel-Haenszel chi square = 15.1,p < 0.0001 for death).For the prediction of recurrent bleeding,the area under the receiver operating characteristic curve was low(63.4%),but the system was satisfactory when predicting mortality(area under the resulting curve,84.3%).Conclusions:After endoscopic therapy for a bleeding peptic ulcer,the Rockall scoring system can identify patients at high risk of death,but it is inadequate for the prediction of recurrent bleeding.
