急诊胃镜诊治急性上消化道出血236例分析

目的探讨急诊胃镜检查对上消化道出血患者病因诊断及内镜下止血对疾病转归的影响。方法针对我院在2010-2013年期间236例上消化道出血患者急诊胃镜检查及治疗结果进行回顾性分析。结果236例急诊胃镜检查病变检出率97．88％（231／236），出血主要病因依次为消化性溃疡、食管胃底静脉曲张、急性胃黏膜病变、贲门及胃恶性肿瘤、Dieulafoy病、Malory—Weiss综合征，其他原因不明。内镜治疗的总有效率为91．95％（217／236），内镜下止血成功率87．71％（207／236），手术率8．90％（21／236），死亡率2．12％（5／236）。结论对于上消化道出血患者，应尽早行急诊胃镜检查明确病因，有活动性出血者用镜下止血是安全而有效的，可提高止血率，降低病死率。

Analyse the diagnosis of upper gastrointestinal bleeding by using emergency gastroscopy

Objective To investigate the diagnosis of upper gastrointestinal bleedingby using emergency gastroscopy and effect of hemostasis under endoscopic on disease. Methods Retrospectively analyze the effect of treatment for 236 patients with upper gastrointestinal bleeding and received emergency gastroscopy in our hospital during 2010 and 2013. Results There were 231 cases in 236 （97.88%, 231/236） were diagnosed as upper gastrointestinal bleeding. The causes of bleeding were mainly peptic ulcer, esophageal and gastric varices, acute gastric mucosal lesions, malignant tumor, cardiac and gastric Dieulafoy disease, Mallory-Weiss syndrome, and otherunknown reasons. Total effective rate of Endoscopic treatment was 91.95% （217/236）, success rate of hemostasis under endoscopic was 87.71% （207/236）, operation rate was 8.90% （21/236）, mortality rate was 2.12% （5/236）. Conclusions Patients who were suspected as upper gastrointestinal bleeding should receive emergency gastroscopy as early as possible, and hemostasis under endoscopy was safe and effective, and it＇s hehfful for raise hemostasis and reduce mortality.