急诊胃镜对肝硬化合并上消化道出血的诊断及治疗价值.docVIP

急诊胃镜对肝硬化合并上消化道出血的诊断及治疗价值 缪丽 自贡市中医医院消化内科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的:比较肝硬化合并上消化道出血的患者进行不同时机的胃镜检查及治疗结果, 探讨急诊胃镜对肝硬化合并上消化道出血的诊断及治疗价值。方法:选择94例在我院进行诊治的肝硬化合并上消化道出血患者的临床资料进行回顾性分析和随访, 其中27例患者进行急诊胃镜诊治 (A组) , 23例患者进行普通胃镜诊治 (B组) , 20例患者为活动性出血急诊胃镜组 (C组) , 24例患者选择保守药物治疗。比较胃镜检查和治疗结果。结果:70例患者接受胃镜检查, 食管胃静脉曲张破裂出血 (64.29%) 是肝硬化合并上消化道出血的主要原因。43例 (61.43%) 患者经胃镜检出出血部位, C组出血部位检出率 (80.0%) 明显高于A组 (66.67%) 和B组 (39.13%) , 有统计学差异。61例患者进行胃镜辅助止血治疗, 止血成功率达到53.19%。A组 (66.67%) 、B组 (60.87%) 和C组 (50.0%) 患者的止血成功率高于D组 (33.33%) , 有统计学差异。另外A (7.41%) 、B (4.35%) 、C (10.0%) 组患者早期再出血率明显低于D组 (37.5%) , 有显著地统计学差异。而四组患者迟发性再出血的几率没有统计学差异。结论:肝硬化合并上消化道出血的患者进行急诊胃镜诊治可尽早明确出血部位以及出血原因, 选择合理的治疗方案, 有效地提高患者止血部位检出率和止血成功率, 降低早期再出血率以及患者1年内死亡率。 关键词： 急诊胃镜; 肝硬化合并上消化道出血; 食管胃静脉曲张; 作者简介：缪丽, E-mail 收稿日期：2017-06-23 The Diagnostic and Therapeutic Values of Emergency Endoscopyin Liver Cirrhotic Patients with Upper Gastrointestinal Bleeding Miu Li Department of Gastroenterology, Zigong Hospital of Chinese Medicine; Abstract： Objective To compare the inspection and treatment outcomes between liver cirrhotic patients with upper gastrointestinal bleeding endoscopically examined at different time, in order to explore the diagnostic and therapeutic values of emergency endoscopy in liver cirrhotic patients with upper gastrointestinal bleeding. Methods 94 cases of liver cirrhotic patients with upper gastrointestinal bleeding hospitalized in our hospital were selected and divided into four groups based on the endoscopy timing, including 27 patients in Group A with the emergency endoscopy within 48 h; 23 patients in Group B with selective endoscopy; 20 patients with active hemorrhage in Group C with emergency endoscopy; 24 patients in Group D with traditional treatment. The different inspection and treatment outcomes were made a comparison between the four groups. Results 70 patients were examined by endoscopy. The main reason of liver cirrhotic with upper gastrointestin