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目的:探讨急诊科上消化道出血的病因构成及特点。方法:回顾性分析我科2010年1月至2012年1月诊治的186例上消化道出血患者的临床资料。结果:(1)上消化道出血主要病因为消化性溃疡46.9%、急性胃黏膜病变12.7%、肝硬化9.0%、胃癌7.2%,贲门撕裂症6.0%。(2)急诊内镜诊断明确的阳性率(95.6%)显著高于非急诊内镜(81.3%),P<0.01。(3)服用非甾体消炎药(NSAIDs)患者急性胃黏膜病变发生率(39.5%)明显高于未服用者(4.1%),P<0.01;服用NSAIDs患者消化性溃疡发生率(52.6%)虽高于未服用者(39.2%),但差异无统计学意义,P>0.05。结论:服用NSAIDs是上消化道出血的重要原因,急性胃黏膜病变发生率较前有所增加,急诊内镜检查有助于上消化道出血的诊断。
Objective: To investigate the causes and characteristics of upper gastrointestinal bleeding in emergency department. Methods: A retrospective analysis of our department from January 2010 to January 2012 diagnosis and treatment of 186 cases of upper gastrointestinal bleeding in patients with clinical data. Results: (1) The main causes of upper gastrointestinal bleeding were peptic ulcer 46.9%, acute gastric mucosal lesion 12.7%, cirrhosis 9.0%, gastric cancer 7.2% and cardia tearing 6.0%. (2) The positive rate of emergency endoscopy (95.6%) was significantly higher than that of non-emergency endoscopy (81.3%), P <0.01. (3) The incidence of acute gastric mucosal lesions (39.5%) in NSAIDs patients was significantly higher than that of non-users (4.1%), P <0.01. The incidence of peptic ulcer in NSAIDs patients was 52.6% Although higher than the non-users (39.2%), the difference was not statistically significant (P> 0.05). Conclusion: Taking NSAIDs is an important cause of upper gastrointestinal bleeding, the incidence of acute gastric mucosal lesions increased compared with the previous, emergency endoscopy is helpful for the diagnosis of upper gastrointestinal bleeding.