急性非静脉曲张性上消化道出血的消化内镜治疗效果分析

目的对急性非静脉曲张性上消化道出血(ANVUGIB)患者应用消化内镜治疗的临床效果进行探析。方法对2017年2月—2018年2月周口市中心医院消化内科收治的87例ANVUGIB患者的临床资料进行回顾分析,根据治疗方法不同分成观察组(45例)和对照组(42例);对照组采取常规专科治疗,观察组应用消化内镜治疗,对比分析两组临床效果。结果观察组止血有效率为97.78%,显著高于对照组的85.72%(P0.05);观察组止血时间、住院时间均短于对照组,且再出血率低,差异有统计意义(P0.05)。结论采用消化内镜治疗ANVUGIB止血效果确切,可有效缩短止血时间和患者住院时间,且可减少再出血发生,有着重要临床价值。     

精细化和全面护理改善消化道出血患者临床症状的应用价值

目的 观察精细化和全面护理的实施效果,分析该护理模式在改善消化道出血患者临床症状中的价值.方法 选取2018年1月至2019年1月于本院收治的消化道出血患者140例,采用随机数字表法将患者分为常规组与观察组,每组各70例.常规组予以常规护理,观察组予以精细化和全面护理.比较两组生活质量改善状况、随访1个月、6个月、12...     

介入治疗在出血性胃十二指肠溃疡病术后大出血的应用评价

目的 评价出血性胃十二指肠溃疡患者在胃大部切除术后大出血时予以介入栓塞治疗的效果。方法 对我院1980～2002年间收治的49例出血性胃十二指肠溃疡患者,在胃大部切除术后大出血时的手术与介入治疗效果进行回顾性比较分析。结果 本组49例患者中,予以再手术治疗26例(再手术组),介入治疗23例(介入治疗组),均取得了较好的疗效。两组在治愈率、病死率、并发症及再出血发生率方面比较,差异无显著性意义(P>>0.05)。但平均住院日及输血量再手术组明显增多,两组比较,差异有极显著性意义(P<0.01)。结论 对于出血性胃十二指肠溃疡患者,术后大出血行介入栓塞治疗是安全有效的,应及早进行;对介人治疗效果不佳者应及时手术。     

高血压脑出血术后再出血的高危因素及其预防

目的 总结高血压脑出血(HCH)术后再出血的危险因素和预防措施。方法 连续记录76例HCH手术患者的病史、体征、诊断、临床分级、治疗方法及病理改变。并对治疗结果进行统计分析。结果 发生再出血8例,其出血的高危因素有长期高血压病史,脑出血后早期即行手术,术中未能发现主要的出血灶或止血不可靠,以及术后未能控制高血压等。结论 术中对主要的出血动脉作可靠电凝止血、术后有效地控制血压是预防再出血的关键。     

两种气囊压迫法防治TURP术后再出血的护理评估

目的比较两种气囊压迫法防治TURP术后出血的疗效及护理。方法按单纯膀胱颈气囊压迫和膀胱颈加肛门内双重气囊压迫分为对照组（41例）和实验组（45例）,分析两组气囊注水量、压迫时间、镇痛泵使用时间、膀胱痉挛好转例数、膀胱冲洗通畅例数、膀胱内血块堵塞例数、再次手术例数。结果经比较,两组除气囊注水量P〉0．05外,其余P〈0．05或P〈0．01,差异均有统计学意义。结论膀胱颈加肛门内双重气囊压迫止血确切,能有效降低再次手术率。加强早期护理干预并规范护理流程对患者术后恢复有明显促进作用。     

门脉高压症断流术后上消化道再出血24例分析

目的:分析门脉高压症术后再出血的常见原因,提高再出血时治疗方案。方法:回顾分析24例贲门周围血管离断术术后出现上消化道再出血患者的临床资料。其中断流不彻底、残留高位或异位高位食管支9例;应激性溃疡5例;新的门奇静脉侧支循环4例;门脉高压性胃炎6例。结果:门脉高压性胃炎者出血量少可保守治疗,断流不彻底、应激性溃疡、新的门奇静脉侧支循环一般出血量大,需再次手术治疗。结论:了解门脉高压症断流术后上消化道再出血的原因后,可以确定正确的治疗方案。     

MELD score can predict early mortality in patients with rebleeding after band ligation for variceal bleeding

AIM:To investigate the outcomes,as well as risk factors for 6-wk mortality,in patients with early rebleeding after endoscopic variceal band ligation (EVL) for esophageal variceal hemorrhage (EVH).METHODS:Among 817 EVL procedures performed for EVH between January 2007 and December 2008,128 patients with early rebleeding,defined as rebleeding within 6 wk after EVL,were enrolled for analysis.RESULT:The rate of early rebleeding after EVL for acute EVH was 15.6% (128/817).The 5-d,6-wk,3-mo,and 6-mo mortality rat...     

The size of cerebral aneurysms in relation to repeated rupture

The size of ruptured cerebral aneurysms in 407 cases were studied angiographically in relation to the number of times of rupture. The size of aneurysms was not influenced by the number of clinically documented episodes of bleeding. Patients with long-term clinical courses of untreated ruptured aneurysms had significantly larger aneurysms than in the general patient population. The result indicates that aneurysmal enlargement is not closely related to their rupture when considering aneurysmal growth in general. The mechanism of growth of cerebral aneurysms is discussed.     

蛛网膜下腔再出血原因分析及预防

[目的]探讨蛛网膜下腔出血（SAH）再出血的危险因素及诱发因素。[方法]78例蛛网膜下腔出血患者住院治疗并随访观察6个月,对31例再出血的SAH患者（病例组）与无再出血的47例SAH患者（对照组）的有关危险因素进行比较。[结果]78例SAH的再出血率是39.7%;再出血组发病年龄﹥60岁,Hunt-Hess分级Ⅲ级及以上、伴高血压、动脉瘤、入院时间﹥24 h的比率均高于对照组。[结论]发病年龄﹥60岁、Hunt-Hess分级Ⅲ级及以上、伴高血压、动脉瘤、入院时间﹥24 h是SAH患者再出血的危险因素。预防再出血需注意控制危险因素,避免诱发因素。     

Increased Fibrinolytic Activity and Body Cavity Coagula

When a large volume of coagulum remains in the body cavity after trauma or surgery, secondary fibrinolysis occurs, which disturbs the hemostatic balance and results in rebleeding. To better understand this condition, we conducted a clinical study on patients with and without coagula and an experimental study on fibrinolytic activity in a rat model. The results of the clinical study showed that when coagula existed in the body cavity, the blood levels of the fibrin degradation products D-dimer and fibrinopeptide Bβ_15–42 remained high compared with when subjects were under similar stress but without the presence of coagula. In the experimental studies, fibrinolytic activity of the omentum, measured by the fibrin plate method, was higher in rats with hemoperitoneum. This suggests that increased fibrinolytic activity may lead to rebleeding from the area of transient hemostasis when coagulum is present in the body cavity. Received: July 8, 1999 / Accepted: May 30, 2000