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目的了解上消化道出血的病因及急诊胃镜检查在上消化道出血的临床应用价值。方法414例上消化道出血患者来诊后或入院后立即进行胃镜检查,生命体征不稳定及高龄患者建立静脉通道、补液、制配、止血、输血、多功能心电监护,血压恢复后即行胃镜检查,用Forrest分类法作为判断出血依据。结果414例患者消化性溃疡269例(65%),急性胃黏膜病变65例(15.7%),胃癌48例(11.6%),食管胃底静脉曲张破裂出血17例(4.1%),Dieulafoy病7例(1.7%),无一例病情加重或死亡。结论上消化道出血常见病因为消化性溃疡、急性胃黏膜病变、胃癌、食管胃底静脉曲张破裂出血,Dieulafoy病增多,急诊胃镜检查可提高诊断阳性率,且安全。
Objective To understand the etiology of upper gastrointestinal bleeding and the clinical value of emergency endoscopy in upper gastrointestinal bleeding. Methods 414 cases of upper gastrointestinal bleeding after admission or admission to the gastroscopy immediately after the instability of vital signs and elderly patients to establish intravenous access, rehydration, preparation, hemostasis, blood transfusion, multi-function ECG monitoring, blood pressure after gastroscopy Check, using Forrest classification as a basis for bleeding. Results Among the 414 patients, 269 (65%) had peptic ulcer, 65 (15.7%) had acute gastric mucosal lesions, 48 (11.6%) had gastric cancer, 17 (4.1%) had esophageal and gastric variceal bleeding, Dieulafoy disease 7 Cases (1.7%), no case of exacerbations or death. Conclusion The common causes of upper gastrointestinal bleeding are peptic ulcer, acute gastric mucosal lesion, gastric cancer, esophageal variceal bleeding and Dieulafoy’s disease. Emergency gastroscopy can improve the diagnostic accuracy and safety.