贵州医科大学学报

2013, v.38;No.161(02) 159-161

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消化内镜治疗上消化道出血后再出血危险因素分析
Risk Factors of Rebleeding in Upper Gastrointestinal Tube after Digestive Endoscopic Haemostasis Treatment

李莉;谭跃;黎振林;莫健莲;
LI Li,TAN Yue,LI Zhenlin,MO Jianlian(Department of Gastroenterology,Yulin Red Cross Hospital of Guangxi,Yulin 537000,Guangxi,China)

摘要(Abstract):

目的:研究消化内镜治疗上消化道出血后再出血的危险因素,探讨降低再出血发生率的方法。方法:收集158例消化内镜治疗的上消化道出血患者的资料,比较发生再出血组(T组)患者与未发生再出血组患者(O组)的年龄、性别、出血量、入院时血红蛋白浓度、血小板计数、血尿素氮浓度、是否发生休克、内镜下活动性出血等资料的差别。结果:158例患者中,22例患者发生再次出血(T组);T组的出血量(240±104)ml及血尿素氮(18.22±4.57)mmol/L高于O组,P<0.05;T组血红蛋白(86.53±7.84)g/L及血小板计数(104.25±44.55)×109/L低于O组(P<0.05),T组发生休克及内镜下活动性出血的比例大于O组(P<0.05);多因素分析结果表明休克、内镜下活动性出血及血红蛋白水平是再出血的独立危险因素。结论:休克、内镜下活动性出血及血红蛋白水平是再出血的独立危险因素。
Objective: To study the risk factors of rebleeding in upper gastrointestinal tract after digestive endoscopic haemostasis treatment,and to explore methods to reduce rebleeding rate.Methods: Retrospective analysis was conducted on 158 upper gastrointestinal bleeding patients that received digestive endoscopic treatment before.Information including age,gender,bleeding amount,admission hemoglobin concentration,platelet counts,blood urea nitrogen concentration,shock rate,active bleeding under endoscope were compared between rebleeding Group(group T) and non-rebleeding group(group O).Results: Rebeeding occurred in 22 cases(group T) of the 158 patients,and it did not happen in the other 136 patients(group O).The bleeding amount(240 ± 104 ml) and blood urea nitrogen concentration(18.22 ± 4.57 mmol/L) in group T were higher than those of group O(120 ± 45ml,10.63 ± 6.35 mmol/L)(P<0.05),while the hemoglobin concentration(86.53 ± 7.84 g/L) and platelet count(104.25 ± 44.55) in patients of group T were lower than those of group O(P<0.05),and the active bleeding rate,shock rate in group T were greater than those in group O(P<0.05).Multivariate analysis showed that shock,endoscopic active bleeding and hemoglobin were independent risk factors to rebleeding.Conclusion: Shock,active bleeding,and hemoglobin are independent risk factors for rebleeding.

关键词(KeyWords): 内窥镜检查,消化系统;上消化道出血;危险因素
endoscopy,digestive system;upper gastrointestinal bleeding;risk factor

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作者(Author): 李莉;谭跃;黎振林;莫健莲;
LI Li,TAN Yue,LI Zhenlin,MO Jianlian(Department of Gastroenterology,Yulin Red Cross Hospital of Guangxi,Yulin 537000,Guangxi,China)

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DOI: 10.19367/j.cnki.1000-2707.2013.02.013

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