BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distin...BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.展开更多
目的分析质子泵抑制剂(proton pump inhibitor,PPI)诱发患者痛风性关节炎急性发作的病例资料,并探讨其可能的机制.方法收集2009-09/2016-11天津医科大学总医院的8例PPI致痛风性关节炎复发患者的资料,并作进一步分析.结果共收集PPI致痛...目的分析质子泵抑制剂(proton pump inhibitor,PPI)诱发患者痛风性关节炎急性发作的病例资料,并探讨其可能的机制.方法收集2009-09/2016-11天津医科大学总医院的8例PPI致痛风性关节炎复发患者的资料,并作进一步分析.结果共收集PPI致痛风性关节炎复发的患者8例,均为男性,初诊断为消化性溃疡(75.0%)或糜烂性胃炎(25.0%),伴高尿酸血症,且尿pH≤6,用药起始至发作的平均时间为6.67 d,临床表现以单关节或多关节红、肿、疼痛和活动受限为主,多伴发热(62.5%).实验室检查主要为用药后白细胞计数、中性粒细胞百分比升高及尿酸升高(75.0%),肌酐及尿素氮降低(87.5%),血清K+降低(P<0.05),Na^+、Cl^-升高(62.5%).停药、对症治疗、非甾体类抗炎药物或激素通常可以缓解.结论 P P I引起患者痛风性关节炎的复发,可能是某些情况下质子泵抑制剂抑制肾脏H^+-K^+-ATP酶或血容量减少的结果 .展开更多
基金Supported by Xi’an Health Commission Residential Training Base Construction Project,No.2023zp09.
文摘BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.
文摘目的探讨脑卒中患者并发急性上消化道出血(upper gastrointestinal hemorrhage,UGH)的影响因素。方法选取福建省立医院急诊科2021年2月—2022年2月收治的120例脑卒中患者作为研究对象,根据是否发生UGH分为对照组(未发生UGH,n=77)和观察组(发生UGH,n=43)。对两组临床资料进行分析,找出发生UGH的相关因素,并提出防治对策。结果观察组在年龄>70岁、经常饮酒、有高血压史、丘脑脑干部位、有消化道病史以及格拉斯哥昏迷评分法(Glasgow coma scale,GCS)≤8分与对照组比较,差异有统计学意义(P<0.05)。两组在性别、糖尿病史、吸烟史以及脑卒中史方面比较,差异无统计学意义(P>0.05)。通过多因素Logistic回归分析,结果显示,年龄>70岁、经常饮酒、有高血压史、丘脑脑干部位、有消化道病史以及GCS评分≤8分为脑卒中发生急性UGH的危险因素,差异有统计学意义(P<0.05)。结论影响脑卒中并发急性UGH的相关因素有年龄>70岁、经常饮酒、有高血压史、丘脑脑干部位、有消化道病史以及GCS评分≤8分,临床工作中应尽早评估其影响因素及病情发展程度,并为患者制订相应的治疗方案。
文摘目的分析质子泵抑制剂(proton pump inhibitor,PPI)诱发患者痛风性关节炎急性发作的病例资料,并探讨其可能的机制.方法收集2009-09/2016-11天津医科大学总医院的8例PPI致痛风性关节炎复发患者的资料,并作进一步分析.结果共收集PPI致痛风性关节炎复发的患者8例,均为男性,初诊断为消化性溃疡(75.0%)或糜烂性胃炎(25.0%),伴高尿酸血症,且尿pH≤6,用药起始至发作的平均时间为6.67 d,临床表现以单关节或多关节红、肿、疼痛和活动受限为主,多伴发热(62.5%).实验室检查主要为用药后白细胞计数、中性粒细胞百分比升高及尿酸升高(75.0%),肌酐及尿素氮降低(87.5%),血清K+降低(P<0.05),Na^+、Cl^-升高(62.5%).停药、对症治疗、非甾体类抗炎药物或激素通常可以缓解.结论 P P I引起患者痛风性关节炎的复发,可能是某些情况下质子泵抑制剂抑制肾脏H^+-K^+-ATP酶或血容量减少的结果 .
