急诊保守治疗与急诊胃镜治疗上消化道出血的临床对比研究

目的 探讨急诊胃镜在治疗上消化道出血中的临床效果.方法 选取2010年1月至2013年1月深圳市人民医院收治的上消化道出血患者100例,采用随机数字表法将所有患者分为两组,各50例.试验组采用胃镜治疗,对照组采用保守治疗.观察两组患者住院时间、住院期间输血量及治疗后止血与再出血情况.结果 治疗后,试验组住院时间和住院期间输血量均显著少于对照组,分别为[（7.2±0.9） d vs（11.3±1.4） d]和[（225.8±39.1） mL vs（363.1±60.7） mL],比较差异均有统计学意义（P〈0.05）.止血情况：试验组显效28例、有效18例、无效4例,对照组显效15例、有效22例、无效13例,两组总有效率分别为92.0%和74.0%,试验组的疗效显著优于对照组（P〈0.05）.成功止血5 d后,试验组再出血1例,对照组再出血7例,再出血率分别为2%和14%;需转为外科手术治疗,试验组3例,对照组10例,手术治疗率分别为6%和20%.结论 急诊胃镜治疗上消化道出血具有止血效果好、术后恢复快等优势,值得临床推广.

Clinical Comparison of the Upper Gastrointestinal Bleeding Treated by Emergency Gastroscopy and Conservative Treatment

Objective To discuss the clinical efficacy of upper gastrointestinal bleeding（UGB） treated by emergency gastroscopy. Methods 100 UGB patients admitted by Shenzhen People＇ s Hospital from Jan. 2010 to Jan. 2013 were selected, and divided into trial group（ 50 cases） and control group（ 50 cases） accord- ing to the random number table method. The gastroscopy was adopted for the trial group and conservative treatment was taken for the control group. The hospitalization time, blood transfusion amount during hospitali- zation, hemostasis and rebleeding of two groups were observed. Results After treatment, hospitalization time and blood transfusion of the trial group was statistically significantly less than the control group with the spe- cific data of [（7.2±0.9） dvs （11.3±1.4） d],[（225.8 ±39.1） mLvs （363.1±60.7） mL]（P〈0.O5）.As for hemostasis,in the trial group,28 cases were markedly effectual, 18 cases were effective,4 cases were invalid. And in the control group, 15 cases were markedly effectual,22 cases were efieetive, 13 cases were invalid. The total efficacy of the two groups were 92.0% and 74.0% respectively（ P 〈 0.05 ）. Rebleeding occurred in one ease of the trial group and seven cases of the control group five days after successful hemosta- sis, the rebleeding rates was 2% and 14% respectively;transference to surgery,3 cases in the trial group and 10 cases in the control group,the surgical treatment rates was 6% and 20% respectively. Conclusion The gastroscopy treatment for UGB has the advantage of better hemostatic effect and rapid postoperative recovery, which is worthy of promotion.