内镜治疗急性上消化道出血效果及预后影响因素探讨.docVIP

内镜治疗急性上消化道出血效果及预后影响因素探讨 　　【摘要】 目的：分析内镜治疗急性上消化道出血效果及预后的影响因素。方法：将2015年2月-2016年2月收治的161例急性上消化道出血患者，按照治疗后有无再发性出血分为对照组（120例未再出血）与观察组（41例再出血），回顾性分析临床资料，分析再出血预后影响因素。结果：出血量、血小板水平、血红蛋白计数、血尿素氮水平、恶性肿瘤出血、支持治疗不足、镜下活动性出血、病灶喷射样出血、PPI后续治疗缺失、入院时休克是导致内镜治疗急性上消化道出血后再出血的相关因素；恶性肿瘤出血、支持治疗不足、镜下活动性出血、血红蛋白计数、病灶喷射样出血及出血量是导致内镜治疗急性上消化道患者再出血的危险因素。结论：急性上消化道出血内镜治疗后存在诸多危险因素，临床应积极开展风险评估，做好再出血的预防与控制。 　　【关键词】 消化道出血； 内镜治疗； 预后； 再出血； 危险因素 　　doi：10.14033/j.cnki.cfmr.2017.13.003 文献标识码 A 文章编号 1674-6805（2017）13-0006-02 　　【Abstract】 Objective：To analyze the influence factors of endoscopic therapy on acute upper gastrointestinal hemorrhage and its prognosis.Method：161 cases of acute upper gastrointestinal bleeding from February 2015 to February 2016 were selected for the study，which were divided into the control group （120 cases without hemorrhage） and the observation group （41 cases with recurrent hemorrhage），according to whether there was no recurrence of bleeding after treatment.Clinical data were retrospectively analyzed，and the factors influencing the prognosis of rebleeding were analyzed.Result：The amount of bleeding，hemoglobin level， platelet count，blood urea nitrogen，malignant tumor hemorrhage，inadequate support treatment，endoscopic bleeding lesions，jet like bleeding，PPI，lack of follow-up treatment shock on admission were the associated factors of acute hemorrhage of upper digestive tract hemorrhage after endoscopic treatment，the differences were statistically significant（P0.05）.Malignant tumor hemorrhage，inadequate support for treatment，active bleeding under microscope，hemoglobin count，hemorrhage and volume of hemorrhage were the risk factor for the treatment of acute upper gastrointestinal tract hemorrhage by endoscopic therapy，the differences were statistically significant（P0.05）.Conclusion：There are many risk factors in the treatment of acute upper gastrointestinal bleeding after endoscopic treatment.The clinical risk assessment should be carried out to prevent and control the bleeding. 　　【Ke