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目的:探讨急性非静脉曲张性上消化道出血(ANVUGIB)的消化内镜诊治及再出血危险因素。方法:选取我院2014-02-2016-04期间收治的196例ANVUGIB患者作为研究对象。采用内镜诊治ANVUGIB,根据首次内镜止血成功后是否再出血,把首次内镜止血成功的患者分为首次有效止血组和再出血组,统计ANVUGIB的首次内镜止血成功率、首次内镜止血成功再出血率、出血原因和再出血危险因素(例如输血治疗等),采用Pearson卡方检验、Yates卡方检验和多因素Logistic回归分析再出血危险因素。结果:首次内镜止血成功率为96.43%(189例),其中32例(16.33%)再次出血。54.08%(106例)的ANVUGIB病因是十二指肠溃疡。输血治疗、肿瘤出血、后续无质子泵抑制剂治疗、a级出血、出血病变直径≥2.0cm、Rockall评分>5分和Blatchford评分>6分是ANVUGIB内镜止血成功后再出血的独立危险因素(均P<0.05)。结论:内镜诊治ANVUGIB的效果明确。十二指肠溃疡是最常见的ANVUGIB病因。ANVUGIB内镜止血成功后再出血的危险因素众多。
Objective: To investigate the digestive endoscopy diagnosis and risk factors of rebleeding in acute non-variceal upper gastrointestinal hemorrhage (ANVUGIB). Methods: A total of 196 ANVUGIB patients admitted to our hospital from February 2014 to June 2016 were selected as the study subjects. Endoscopic diagnosis and treatment of ANVUGIB, according to whether the first endoscopic hemostasis after the success of bleeding, the first successful endoscopic hemostasis patients are divided into the first effective hemostatic group and rebleeding group statistics ANVUGIB success rate of the first endoscopic hemostasis, first endoscopic hemostasis The rate of successful rebleeding, the cause of bleeding, and the risk of rebleeding (such as transfusion therapy). The risk factors of rebleeding were analyzed by Pearson Chi-square test, Yates chi-square test and multivariate Logistic regression. Results: The success rate of first endoscopic hemostasis was 96.43% (189 cases), of which 32 cases (16.33%) blew again. 54.08% (106 cases) of the cause of ANVUGIB is duodenal ulcer. Blood transfusion, tumor hemorrhage, subsequent aseptic pump inhibitor treatment, grade a bleeding, bleeding lesion diameter ≥2.0 cm, Rockall score> 5 and Blatchford score> 6 were independent risk factors for rebleeding after ANVUGIB endoscopic hemostasis was successful All P <0.05). Conclusion: Endoscopic diagnosis and treatment of ANVUGIB clear effect. Duodenal ulcer is the most common cause of ANVUGIB. There are many risk factors for ANHUGIB bleeding after successful endoscopic hemostasis.