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目的研究急诊内镜治疗上消化道大出血的疗效。方法临床上将216例上消化道大出血患者按随机和患者自愿分为三组:A组98例,在出血24h内行急诊内检查及内镜下止血治疗;B组70例,在出血24h后行内镜下检查及内镜下止血治疗;C组48例,行内科保守治疗。结果 A组的病因检出率为92.86%(91/98),显著高于B组的65.71%(48/70)和C组的63.64%(7/11),差异有统计学意义(P<0.05);A组止血成功率为95.92%(94/98),B组为91.42%(64/70),均显著高于C组的72.92%(35/48),差异有统计学意义(P<0.05);随访1个月,A组和B组的再出血率分别为3.19%(3/94)、7.81%(5/64),均明显低于C组的25.71%(9/35),差异有统计学意义(P<0.05)。结论急诊内镜治疗可极大提高患者救治成功率,降低术后再出血率,可作为救治上消化道大出血,尤其是活动性出血患者治疗的首选方法。
Objective To study the efficacy of emergency endoscopic treatment of upper gastrointestinal bleeding. Methods A total of 216 cases of upper gastrointestinal bleeding were randomly divided into three groups according to randomization and the patients were randomly divided into three groups: group A (n = 98), undergoing emergency internal examination and endoscopic hemostasis within 24 hours after hemorrhage. Group B (n = 70) Endoscopic examination and endoscopic hemostasis; C group of 48 patients underwent conservative treatment. Results The detection rate of etiology in group A was 92.86% (91/98), significantly higher than 65.71% (48/70) in group B and 63.64% (7/11) in group C, with significant difference (P < 0.05). The success rate of hemostasis in group A was 95.92% (94/98) in group B, 91.42% (64/70) in group B, which was significantly higher than that in group C (72.92%, 35/48) (P <0.05). The rate of rebleeding in group A and group B was 3.19% (3/94) and 7.81% (5/64) respectively, which were significantly lower than those in group C (25.71%, 9/35) , The difference was statistically significant (P <0.05). Conclusion Emergency endoscopic treatment can greatly improve the success rate of treatment and reduce the rate of postoperative hemorrhage, which can be used as the treatment of upper gastrointestinal bleeding, especially active bleeding in patients with the preferred method of treatment.