内窥镜在急症上消化道大出血中的应用

目的：探讨急症内窥镜（内镜）介入对上消化道大出血的诊断及治疗的意义。方法：对急症上消化道大出血患者在１２～４８小时内进行胃镜检查，检查前用０．００８％去甲肾上腺素冰盐水洗胃。急症内镜检查组３９４例，非内镜检查１０５例为对照组。结果：诊断符合率内镜检查组为９８．４８％，对照组为６３．８１％；病死率内镜检查组为４．５７％，对照组为２８．５７％，Ｐ均＜０．０１。结论：急症内镜检查可以及时明确诊断，又可介入进行直接治疗；急症上消化道大出血时内镜介入可明显提高诊断率，降低病死率。

Application of gastroscopy in emergency patients with upper gastrointestinal hemorrhage

Objective:To evaluate significance of gastroscopy for diagnosis and treatment in emergency patients with upper gastrointestinal hemorrhage.Methods:Gastroscopy was performed in patients with upper gastrointestinal hemorrhage within 12 to 48 hours.Ice salt solution containing noradrenaline was used for gastric lavage before gastroscopy.Results:Among 499 cases,emergency gastroscopy examination was performed in 394 cases,and the other 105 cases without gastroscopy served as control group.Correct diagnostic rates were 98 48% and 63 81% in gastroscopy group and control group respectively.Mortality was 4 57% and 28 57% in gastroscopy group and control group respectively,and the differences were significant (all P <0 01).Conclusions:The correct diagnostic rate was obviously increased while mortality was decreased in application of gastroscopy in emergency patients with upper gastrointestinal hemorrhage.Meanwhile,emergency gastroscopy may not only help to early diagnose disease,but also use to effectively treat upper gastrointestinal hemorrhage.