急诊胃镜检查及治疗上消化道出血

我院于1994至1999年对142例上消化道出血病人行急诊内镜检查,对出血原因进行分析。并经内镜对出血灶进行局部止血治疗,现报告如下。 1 临床资料 1.1 病例选择能承受急诊胃镜检查的上消化道出血病人142例,男98例,女44例,年龄18～76岁,其中以呕血为首发症状者51例,以黑便为首发症状者91例。出血后≤12h胃镜检查者38例,12～24h检查者61例,24～48h检查者43     

上消化道出血急诊胃镜检查治疗及护理

上消化道大出血是临床上常见的急危重症之一,以发病突然、发展迅速、病死率高为特点,常可威胁患者的生命。急诊胃镜检查已成为明确诊断和抢救治疗上消化道出血的重要技术之一。由于患者大多病情危重或病因未明,生命体征不稳定,增加了检查的风险。     

急诊胃镜检查对上消化道出血的诊治价值

急诊胃镜检查是指在出血后48h内进行的胃镜检查,是上消化道出血病因的首选检查方法,还可根据病变的特征判断是否继续出血或估计再出血的危险性,并同时进行内镜止血治疗,急诊胃镜以其特有的优点,越来越受到临床医师的注重。本文对本院自2002年1月至2008年1月6年间胃镜检查上消化道出血患者347例的临床资料进行回顾性分析,整理,探讨急诊胃镜检查对上消化道出血的诊治价值。1资料与方法1.1一般资料347例患者中,男258例,女89例,男女之比为:3.4∶1,年龄13~82岁,临床表现为单纯呕血者39例,单纯黑便者175例,呕血伴黑便者133例。出血后48h内进行胃镜检查159例(以下称为A组),48h后进行胃镜检查188例(以下称为B组),两组病例的性别、年龄、出血量、出血方式无显著差异。1.2方法胃镜检查前常规做好术前准备工作,纠正休克,补充血容量,改善贫血,如有大量活动性出血,先插胃管抽吸胃内积血,并用生理盐水灌洗。镜下有活动性出血者用8%去甲肾上腺素盐水20~30ml、凝血酶1000~2000U局部喷洒止血。2结果2.1两组出血病因及所占比率如表1。表1两组出血原因组别出血例数A组所占比例出血例数B组所占比例胃...     

急性上消化道出血急诊胃镜检查体会

急诊胃镜作为上消化道出血诊断和治疗的有效方法,应用越来越广泛。本文对我院1995年6月～2002年6月应用胃镜检查上消化道出血患者284例的资料进行回顾性分析,评价急诊胃镜的诊治价值。 1 资料与方法 1.1 一般资料 284例患者中,男229例,女55例。男女比例为4.16∶1,年龄16～79岁。临床表现为单纯呕血58例(20.4％),单纯黑便165例(58.1％),二者兼有61例(21.5％)。估计出血量<500 ml 84例(29.6％),500～1000 ml 148例(52.1％),>1000 ml 52例(18.3％)。出血后48 h内行胃镜检查156例(简称A组);48 h后行胃镜检查128例(简称B组)。两组病例的性别、年龄、出血方式及出血量等情况大体相似。     

上消化道出血急诊胃镜检查的体会

我院胃镜室1982年4月～1986年5月对60例上消化道出血患者进行急诊胃镜检查,现将体会总结如下。一.急性胃镜检查的适应症及禁忌症本组病员年龄最小的15岁,最大的82岁,受检时多数Hb5～10克,个别病人Hb<5克但顺利受检。据我们的检查体会,病人的年龄、性别与出血量的大小并不十分重要,关键是病人一般情况要好,血压稳定,心肺功能要能够耐受检查。我们的实践经验证明只要操作轻柔、敏捷、谨慎小心,急性出血期间作胃镜检查是安     

急诊胃镜检查和治疗在急性上消化道出血疾病中的作用探讨

目的观察急诊胃镜检查及治疗在急性上消化道出血中的应用效果。方法病例纳入时间范围为2017年9月～2019年9月,均为因急性上消化道出血疾病到我院接受治疗患者,共计60例,按照随机数字表法分组,常规治疗(对照组)、急诊胃镜检查和治疗(观察组)均为30例,比较两组治疗效果。结果比较两组症状消失时间及住院时间,观察组均较对照组低,差异有统计学意义(P 0.05);观察组治疗效果为93.3%,对照组为70.0%,差异有统计学意义(P 0.05);治疗后再出血发生率观察组为3.3%,少于对照组(16.7%),差异有统计学意义(P 0.05)。结论针对急性上消化道出血疾病患者行急诊胃镜检查及治疗,对于促进患者症状消失、降低再出血发生率作用显著,值得临床借鉴。     

紧急胃镜检查对上消化道出血的诊断价值

紧急镜检对上消化道出血的病因诊断有重要的临床意义,我们从1986年12月至1993年3月对上消化道出血原因不明540例患者进行了紧急胃镜检查。现总结如下。临床资料其中出血后24小时内镜检392例,出血后     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

急诊胃镜检查上消化道出血的临床体会

急诊胃镜检查即在患者发病24~48h内行胃镜检查，对上消化道出血的病因诊断及行内镜下介入治疗为临床有效的诊治手段，应用越来越广泛，但在基层医院尚未普及，本文对146例急诊胃镜检查取得满意效果，现就本组资料报告如下。 1 一般资料 本院自1997-07~2001-07中，因呕血和(或)黑便(上消化道出血)就诊，进行急诊胃镜检查共146例，其中男96例，女50例，年龄10~78岁，平均41.1±2.3岁。 2 检查方法及结果 内镜采用日本OlympusGIF-XQ 30或Fujinon 88型，全部病例均在发病后24h内行胃镜检查，检查结果：十二指肠球部溃疡72例，胃溃疡23例，…     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

上消化道出血急诊胃镜检查96例分析

我院1997年1月～2003年12月胃镜检A上消化道出血患者96例，现将检查结果报道如下：     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

上消化道出血急诊胃镜检查120例分析

我院从1994年5月～2000年8月对120例上消化道出血患者24小时内行急诊胃镜检查,现分析报告如下。     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

上消化道出血急诊胃镜检查的经济学分析

Objective To value of economic with emergency endoscopy in the diagnosis and treatment of massive upper gastrointestinal hemorrhage. Methods I00 patients with upper gastrointestinal hemorrhage were ran-domly divided into emergency endoscopy group (group A) 48 cases and non emergency endoscopy group (group B) 52 cases. Then the correct diagnosis rates, rebleeding rates, complication rates, mean hospitalization days, the en-doscopy costs, the blood transfusion costs, the drugs costs and the total hospitalization costs of two groups were evalu-ated and the cost effect ratio (C/E) was calculated. Results Thecorrect diagnosis rates in A group (100. 0%) were higher than the B group(90. 2%)(x2 =4.01,P <0. 05) ;The endoscopy costs of group A (714. 78±263.54) yuan were higher than the group B (383.57 ±251.72) yuan(t = 2. 778, P < 0. 01) ; Rebleeding A group (6. 7%) were sig-nificantly lower than B group(26. 8%) (x2 = 4. 13 ,P < 0. 05) ; The total hospitalization costs in group A (2785.76 ± 353.26) yuan were lower than group B (3527. 76 ± 555.62) yuan (t = 2. 898, P < 0. 01) ; The C/E of group A (2785.76) yuan per patient were lower than the group B(3527.76) yuan per patient (t = 2. 239 ,P < 0. 01). Con-dusion Emergency endoscopy is economical in the diagnosis and treatment of massive upper gastrointestinal hereof-rhea.     

急诊胃镜检查上消化道出血418例分析

随着胃镜在基屋医院的普及，急诊胃镜检查作为上消化道出血诊断的最直接最可靠的方法，在临床上应用越来越广泛。本院近15年胃镜检查共11023人次：因上消化道出血行胃检查共506例次，占4．6％，其中急诊胃镜检查418例次，占82．6％。对418例的临床资料进行回顾性分析，以评价基层医院急诊胃镜检查的应用价值。     

上消化道出血急诊胃镜检查的经济学分析

目的上消化道出血急诊胃镜检查的经济学评价。方法将100例上消化道出血患者随机分为急诊胃镜组（A组）48例及非急诊胃镜组（B组）52例,两组患者的确诊率、再出血率、病死率、并发症发生率、平均住院日指标的观察及费用的统计,计算两组患者的成本效果比。结果A组确诊率（100．0％）高于B组（90．2％）（X2=4．01,P〈0．05）;A组胃镜检查费（714．78±263．54）元明显高于B组（383．57±251．72）元（t=2．778,P〈0．01）;再出血率A组（6．7％）明显低于B组26．8％（X2=4．13,P〈0．05）;A组总住院费为（2785．76±353．26）元明显低于B组（3527．76±555．62）元（t=2．898,P〈0．01）;成本效果比A组为2785．76元／人,低于B组3527．76元／人（t=2．239,P〈0．01）。结论上消化道出血急诊胃镜检查有临床价值且成本效果明显。