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目的研究不同时机急诊胃镜对肝硬化出血治疗价值。方法 120例具有完整病历资料的肝硬化出血患者,随机数字表法分为急诊胃镜组(90例)与非急诊胃镜组(30例),将急诊胃镜组划分为A组(32例)、B组(30例)、C组(28例),A、B、C组患者分别于入院<6 h、6~12 h、12~48 h内行胃镜检查,非急诊胃镜组(D组)于入院48 h后行胃镜检查,根据A、B、C、D组具体病情进行胃镜下治疗。对四组的再出血率、病死率、并发症发生率进行比较,统计分析四组的平均住院时间、住院期间输血量。结果急诊胃镜组的再出血率、病死率、并发症发生率显著低于非急诊胃镜组,差异具有统计学意义(P<0.05);非急诊胃镜组的平均住院时间、输血量、治疗费用显著高于A、B、C组,差异具有统计学意义(P<0.05);A、B组平均住院时间、输血量、治疗费用均优于C组,差异具有统计学意义(P<0.05)。结论急诊胃镜检查越早越好,及早对肝硬化出血患者进行急诊胃镜检查有利于止血和改善预后,临床效果显著,具有重要意义。
Objective To study the value of emergency gastroscopy for treatment of cirrhosis and hemorrhage at different time. Methods One hundred and twenty patients with complete cirrhosis with cirrhosis were divided into emergency gastroscopy group (n = 90) and non-emergency gastroscopy group (n = 30). The emergency gastroscope group was divided into group A (n = 32) Group C (n = 30), group C (n = 28), group A, B, and group C underwent gastroscopy within 6 h, 6 to 12 h and 12 to 48 h, respectively. Patients in non-emergency endoscopy group (group D) 48 h after gastroscopy, according to A, B, C, D group of specific conditions of endoscopic treatment. The rebleeding rate, case fatality rate and complication rate of the four groups were compared. The average length of hospital stay and blood transfusion during hospitalization were statistically analyzed. Results The rates of rebleeding, fatality and complication in emergency gastroscope group were significantly lower than those in non-emergency gastroscope group (P <0.05). The average length of hospital stay, blood transfusion and treatment cost were significantly higher in non-emergency gastroscope group The difference was statistically significant (P <0.05). The average length of hospital stay, blood transfusion, and treatment costs in group A and group B were significantly higher than those in group C (P <0.05). Conclusion Emergency gastroscopy as soon as possible, early emergency cirrhosis patients with gastroscopy is conducive to stop bleeding and improve prognosis, clinical effect is significant, of great significance.