摘要
目的:评估胃溃疡并发出血(gastric ulcer complicated with hemorrhage,GUCH)患者再出血的影响因素。方法:回顾性分析2019年6月-2021年6月笔者所在医院收治的95例GUCH患者的临床资料,根据入院治疗后患者是否再出血将其分为再出血组(25例)与未再出血组(70例)。收集患者临床指标及入院治疗后血清GAS、MTL水平,采用多因素Logistic回归分析GUCH患者再出血的影响因素。结果:再出血组平均年龄、溃疡直径均明显大于未再出血组(P<0.05),Hp感染、胃溃疡A1期、胃溃疡史、吸烟史、饮酒史及非甾体类消炎药(non steroidal anti-inflammatory drugs,NSAIDs)应用率均明显高于未再出血组(P<0.05),使用消化内镜治疗率明显低于未再出血组(P<0.05)。再出血组血清GAS(172.75±20.07)ng/L、MTL(192.56±23.41)ng/L,均明显高于未再出血组(P<0.05)。多因素Logistic回归分析结果显示,Hp感染、胃溃疡A1期、NSAIDs应用、GAS、MTL均为GUCH患者再出血的独立危险因素(P<0.05),而使用消化内镜治疗为GUCH患者再出血的独立保护因素(P<0.05)。结论:Hp感染、胃溃疡A1期、NSAIDs应用、GAS、MTL均为GUCH患者再出血的独立危险因素,而使用消化内镜治疗为其独立保护因素,可通过对GUCH患者治疗后血清GAS、MTL水平进行监测采取相关治疗措施,以预防再出血的发生。
Objective:To evaluate the influence factors of rebleeding in patients with gastric ulcer complicated with hemorrhage(GUCH).Method:The clinical data of 95 patients with GUCH admitted in our hospital form June 2019 to June 2021 were retrospective analyzed,and they were divided into the rebleeding group(25 cases)and the non-rebleeding group(70 cases)according to whether they had rebleeding after admission.Clinical indicators and serum GAS and MTL levels after admission were collected.Multivariate Logistic regression analysis was used to explore the influencing factors of rebleeding in patients with GUCH.Result:The average age and ulcer diameter of the rebleeding group were significantly higher than those in the non-rebleeding group(P<0.05),the ratio of Hp infection,gastric ulcer stage A1,gastric ulcer history,smoking history,drinking history and non steroidal anti-inflammatory drugs(NSAIDs)application were significantly higher than those of the non rebleeding group(P<0.05).The ratio of treatment with digestive endoscopy was significantly lower than that of the non-rebleeding group(P<0.05).Serum GAS(172.75±20.07)ng/L and MTL(192.56±23.41)ng/L of the rebleeding group were significantly higher than those of the non-rebleeding group(P<0.05).Multivariate Logistic regression analysis showed that Hp infection,gastric ulcer stage A1,NSAIDs application,GAS,MTL were independent risk factors for rebleeding in patients with GUCH(P<0.05),while treatment with digestive endoscopy was independent protective factor for rebleeding in patients with GUCH(P<0.05).Conclusion:Hp infection,gastric ulcer stage A1,NSAIDs application,GAS and MTL were independent risk factors of rebleeding in patients with GUCH,while the treatment with digestive endoscopy was the independent protective factor.By monitoring the serum GAS and MTL levels of patients with GUCH after treatment and taking relevant treatment measures,we can prevent the occurrence of rebleeding.
作者
王凤霞
WANG Fengxia(Wuhan Jihe Hospital,Wuhan 430050,China)
出处
《中外医学研究》
2021年第31期40-43,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
胃溃疡
再出血
胃泌素
胃动素
Gastric ulcer
Rebleeding
Gastrin
Motilin
