不同时机急诊胃镜检查对肝硬化合并上消化道出血的诊疗价值研究

摘要

Objective:To study the value and research of different timing of emergency gastroscopy on hepatocirrhosis with upper gastro-intestinal hemorrhage diagnosis.Methods:78 cases of liver cirrhosis combined with upper gastrointestinal bleeding were received in our de-partment from March 2013 to March 2015.According to the time of gastroscopy examination in 6h,6～12h and 12～48h after admission,they were divided into Ⅰ group(26 cases),Ⅱ group(26 cases)and Ⅲ group(26 cases),and the corresponding treatment was given accord-ing to the results of the examination.Of all patients bleeding rate and treatment effect were compared.Results:The detection rate of bleeding site in group Ⅰ was significantly higher than that in group Ⅱ and group Ⅲ(P＜0.05).while,group Ⅱ was significantly higher than that in group Ⅲ(P＜0.05);Compared with group Ⅱ,group Ⅰ and group Ⅱ were all smaller in the difference of successful hemostasis rate and the incidence of short－term complications(P＞0.05),but the successful hemostasis rate and incidence of short－term complications of group I were significantly higher than that of group Ⅲ(P＜0.05).Conclusion:Emergency gastroscopy in 6h and 6～12h has a better advantage in diagnosis and treatment of liver cirrhosis with digestive tract bleeding.The time of gastroscopy is an important factor affecting the detection rate of the bleeding site,the effect of treatment and the prognosis of the prognosis.The patient should be given an emergency gastroscopy in 12h as soon as possible.%目的:对不同时机急诊胃镜检查对肝硬化合并上消化道出血的诊疗价值进行研究.方法:以我科2013 年3 月～2015年3月接收的78例肝硬化合并上消化道出血患者为研究对象,根据入院后6h内、6～12h及12～48h进行胃镜检查时机,将其分别分为Ⅰ组(26例)、Ⅱ组(26例)、Ⅲ组(26 例),并根据检查结果给予相应治疗.对各组患者出血部位检出率、治疗效果进行对比.结果:在出血部位检出率上,Ⅰ组患者出血部位检出率明显高于Ⅱ组(P＜0.05)、Ⅲ组患者(P＜0.05),Ⅱ组患者出血部位检出率明显高于Ⅲ组(P＜0.05);在治疗效果上,Ⅰ组与Ⅱ组患者、Ⅱ组与Ⅲ组患者在成功止血率上差异较小(P＞0.05),而I组患者在成功止血率上明显高于Ⅲ组(P＜0.05);在短期并发症发生率上,Ⅰ组与Ⅱ组患者、Ⅱ组与Ⅲ组患者在并发症发生率上差异较小(P＞0.05),而Ⅰ组患者在并发症发生率上明显高于Ⅲ组(P＜0.05).结论:6h内与6～12h急诊胃镜检查在肝硬化合并消化道出血诊疗方面更具优势,胃镜检查时间是影响患者出血部位检出率、治疗效果与预后的重要因素,应尽早在12h内给予患者急诊胃镜检查.