Forrest分级和Rockall评分对消化性溃疡大出血患者预后的判断.docVIP

Forrest分级和Rockall评分对消化性溃疡大出血患者预后的判断 Rockall评分对消化性溃疡大出血患者预后的判断价值.方法选取 2006年9月~2009年8月在我院住院治疗的221例确诊为消化性溃疡大出血患者,人院后给予药物治疗及内镜下 治疗.治疗药物的选择,治疗时机及内镜下治疗方式的选择无显着性差异.平均随访时间为5个月(0--12个月). 按照Forrest分级,Rockall评分对患者再出血发生率及死亡率分别进行评估.按Forrest分级,Ia33例,Ib79 例,a63例,b37例,c9例;按Rockall评分,0分者6例,1分者7例,2分者11例,3分者27例,4分者21 例,5分者45例,6分者40例,7分者34例,8分者17例,gt;8者13例.结果按Forrest分级,Forrest分级Ia级 者再出血率为84.85(28/33),Ib级者再出血率为51.9O(41/79),11a级者再出血率为39.68(25/63),IIb 级者再出血率为21.62(8/37),1Ie级者再出血率为11.11(1/9)(Plt;O.05).按Rockall评分分组,Rockall评 分O～2分者无死亡;3～4分者无死亡;5分者无死亡;评分6分者死亡率2.5O(1/19);评分7分者死亡率5.88 (2/34);评分8分者死亡率23.53(4/17);评分gt;8分者死亡率69.23(9/13)(Plt;O.05).结论对于消化性溃 疡大出血患者,Forrest分级与再出血发生率有相关性,适用于临床及胃镜下作为选择止血方法的依据;而Rockall 评分则与死亡率有相关性,适合于临床作为判断患者死亡风险的依据,并进而指导临床治疗方案的选择. 【关键词】上消化道大出血;Forrest分级;Rockall评分 【中图分类号】R573.1【文献标志码】A【文章编号11674--2257(2011)Olk一0344--03 Progn~isofForrestclassificationandRockallscoreforseverepepticulcerbleedingpatients ZHANGZhan-jie,yUHong-gang,SHENLei.Jie-ping (DepartmentofGastroenterology,WuhanUniversityRenminHospital,Wuhan,Hubei430060,China) [Abstract]ObjectiveToinvestigatethepredictivevalueofForrestclassificationandRockallscoretoprognosis ofseverepepticulcerbleedingpatientsinaccessingrebleedingrateandmortalityrate,.MethodsTwohundredand twenty-oneinpatientsinthishospitalfromSeptember2006toAugust2009,whosediagnosiswasseverepepticulcer bleeding,weregivendifferentmedicalandendoscopictreatmentwithoutsignificantdifferenee,.Theywerefollowedup formean5months(O一12months),thenwereaccessedbyForrestclassificationandRockallscoreseparately.By Forrestclassification,therewere33.79.63.37.9patientsingradeIa,Ib,Ⅱa,Ⅱb,1Icrespectively;andbyRoekall score,therewere6,7,l1,27,21,45,4O,34,17,13patientswithscoreof0,l,2,3,4,5-6,7,8,gt;8respectively.The rehleedingrateandmortalityratewereobserved.ResultsRehleedingrateofForrestIagradewas84.85(28/ 33).ForrestIbgradewas51.90(41/79).ForrestIIagradewas39.68(25/63).Forrest1Ibgradewas21. 62(8/37).ForrestHcgradewas11.11(1/9)(Plt;0.05).MortalityrateofpatientswithRockallscor