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目的探讨急诊内镜在消化道肿瘤患者上消化道出血中的诊疗价值。方法选择2012年6月至2014年5月间收治的115例消化道肿瘤致上消化道出血患者作为研究对象,A组(40例)患者在出血24 h内行急诊内镜检查并进行止血治疗,B组(40例)患者在出血24 h后行内镜检查并进行止血治疗,C组(35例)患者行内科保守治疗,回顾性分析其临床资料,比较3组患者的诊疗情况。结果 A组患者的病因检出率、止血成功率明显高于B组和C组,而3个月复发率明显低于B组和C组,组间差异有统计学意义(P<0.05)。A组患者的止血时间明显短于B组和C组,差异有统计学意义(P<0.05)。A组、B组、C组的不良反应发生率差异有统计学意义(P>0.05)。随访3个月,A组患者的诺丁汉健康调查问卷(NHP)评分明显优于B组和C组,差异有统计学意义(P<0.05)。结论急诊内镜应用于消化道肿瘤患者上消化道出血能够获得更高的病因检出率和止血成功率,并且可缩短止血时间,降低复发率,显著改善患者的生活质量,具有重要的诊疗价值。
Objective To investigate the value of emergency endoscopy in the diagnosis and treatment of upper gastrointestinal bleeding in patients with gastrointestinal cancer. Methods One hundred and fifteen patients with upper gastrointestinal hemorrhage who underwent gastrointestinal tumor in our hospital from June 2012 to May 2014 were enrolled in this study. Patients in group A (40 cases) underwent emergency endoscopy and hemostasis within 24 hours after hemorrhage. Patients in group B (40 cases) underwent endoscopy and hemostasis 24 hours after hemorrhage. Patients in group C (35 cases) underwent conservative medical treatment. The clinical data were retrospectively analyzed. The diagnosis and treatment of the three groups were compared. Results The detection rate and success rate of hemostasis in group A were significantly higher than those in groups B and C, while the recurrence rates at 3 months were significantly lower than those in groups B and C (P <0.05). The bleeding time of group A was significantly shorter than that of group B and C (P <0.05). There were significant differences in the incidence of adverse reactions between groups A, B and C (P> 0.05). The 3-month follow-up showed that the Nottingham Health Questionnaire (NHP) score of group A was significantly better than that of group B and C (P <0.05). Conclusions The application of emergency endoscopy in upper gastrointestinal bleeding in patients with gastrointestinal cancer can obtain higher detection rate of hemorrhage and success rate of hemostasis, and can shorten the time of hemostasis, reduce the recurrence rate and significantly improve the quality of life of patients, which is of great value in diagnosis and treatment .