摘要
目的分析上消化道出血经内镜套扎治疗后再出血的危险因素。方法选择46例上消化道出血经内镜套扎治疗的患者为研究对象,根据内镜套扎治疗后是否发生再出血将患者分为两组,其中20例再出血患者为观察组,26例未再出血的患者为对照组。对两组患者年龄、性别、出血量、血尿素氮浓度、血小板及血红蛋白、入院时休克情况、内镜下活动性出血以及病灶喷射样出血等指标进行统计,先进行单因素分析,对单因素分析有统计学意义的指标进行多因素分析。结果两组患者出血量、血尿素氮浓度、血红蛋白、血小板水平以及患者入院时休克发生率、恶性肿瘤出血率、活动性出血和病灶喷射样出血率比较,差异均有统计学意义(均P <0. 05)。将上述单因素分析有统计学意义的变量纳入多因素logistics回归模型,结果显示出血量、血红蛋白水平、恶性肿瘤出血、活动性出血及病灶喷射样出血为患者上消化道再出血的独立危险因素(P <0. 05)。结论上消化道出血经内镜套扎治疗后再出血的危险因素主要包括出血量、血红蛋白水平和恶性肿瘤出血及患者内镜下活动性出血与患者病灶喷射样出血,对于这些因素需加强防护。
Objective To analyze the risk factors for re-bleeding after treating upper gastrointestinal bleeding by endoscopic ligation. Methods Forty-six upper gastrointestinal bleeding patients treated with endoscopic ligation were enrolled as objects. The patients were divided into two groups according to the occurrence of re-bleeding after endoscopic ligation,including 20 patients with re-bleeding(observation group)and 26 patients without re-bleeding(control group). The age,gender,blood loss,blood urea nitrogen content,platelet and hemoglobin,shock at admission,endoscopic active bleeding and jet-like bleeding of the lesions were statistically analyzed in the patients of both groups. The univariate analysis was performed,then the indices with statistical difference were enrolled in multivariate analysis. Results There were statistical differences in the blood loss,blood urea nitrogen content,hemoglobin,platelet level,incident rate of shock at admission,rate of malignant tumor bleeding,active bleeding and jet-like bleeding of the lesion between the patients of both groups(P < 0. 05). The indices above with statistical difference in the univariate analysis were enrolled in multivariate logistic regression model. The result showed that blood loss,hemoglobin level,malignant tumor bleeding,active bleeding and jet-like bleeding of the lesion were the independent risk factors for re-bleeding in the patients with upper gastrointestinal bleeding(P < 0. 05). Conclusion The risk factors for re-bleeding after treating upper gastrointestinal bleeding by endoscopic ligation includes blood loss,hemoglobin level,malignant tumor bleeding,endoscopic active bleeding and jet-like bleeding of the lesion.Enhanced protective provision for those factor should be performed.
作者
甘育林
李建华
况洪娟
GAN Yulin;LI Jianhua;KUANG Hongjuan(Department of Internal Medicine,Bajing Coalmine Workers' Hospital of Jiangxi Province,Gaoan,Jiangxi 330812,China)
出处
《微创医学》
2018年第6期763-765,共3页
Journal of Minimally Invasive Medicine
关键词
上消化道出血
内镜套扎治疗
再出血
危险因素
Upper gastrointestinal bleeding
Endoscopic ligation
Re-bleeding
Risk factors
