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目的 了解十二指肠溃疡并大出血的急诊内镜特点并分析其与不良预后的关系 ,以便通过胃镜所示的高危因素预警不良预后 ,尽早采取恰当的治疗方式。方法 收集 330例十二指肠溃疡并大出血病例的胃镜结果 ,将其表现分类 ,通过二值多元 L ogistic回归方法进行分析 ,筛选出有意义的高危因素。结果 发现十二指肠溃疡并大出血病例胃镜下所见的溃疡面大血凝块、深溃疡病灶与死亡、高风险急诊外科手术等不良预后明显相关。结论 当十二指肠溃疡并大出血患者急诊内镜下出现上述高危因素并已进行了强有力的抑酸和内镜治疗后仍未能止血时 ,应尽早外科手术治疗。
Objective To understand the characteristics of emergency endoscopy in patients with duodenal ulcer and major bleeding and to analyze its relationship with poor prognosis so as to predict the adverse prognosis by high risk factors indicated by endoscopy and take appropriate treatment as soon as possible. Methods The gastroscope results of 330 patients with duodenal ulcer and bleeding were collected. The performance of the method was classified and analyzed by binary multivariate logistic regression to screen out the risk factors of interest. The results showed that duodenal ulcer and bleeding in cases seen under endoscopy ulcers large blood clots, deep ulcer lesions and death, high risk emergency surgery and other adverse prognosis was significantly related. Conclusions Surgery should be performed as soon as possible after emergent endoscopic emergent endoscopic treatment of duodenal ulcer and major bleeding has failed to stop the bleeding due to strong acid suppression and endoscopic therapy.