胃肠道溃疡出血患者的生存状况研究
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摘要
目的探讨影响胃肠道溃疡出血患者生存状况的危险因素。方法收集2013年1月至2017年2月份来我院就诊的345例胃肠道溃疡出血患者的临床资料,依据最后的治疗结果分为治愈组与死亡组,然后用统计学方法来分析比较两组患者的临床资料的差异。结果治愈组患者的年龄、合并症、Forrest分级、休克、凝血功能异常、再出血、胃肠镜下钛夹止血、内镜下药物止血及手术止血的比例均低于死亡组患者;治愈组患者的血清白蛋白水平明显高于死亡组患者:多因素分析结果显示患者的年龄、合并症及再出血等均为胃肠道溃疡出血患者发生死亡的独立危险因素。结论高龄、合并症及再出血均可以导致胃肠道溃疡出血患者的死亡,在临床工作中要对有上述情况的胃肠道溃疡出血患者给予高度的重视。
Objective To explore the risk factors affecting the living conditions of the pateints with gastrointestinal bleeding uler.Methods 345 cases gastrointestinal bleeding uler patients' clinical data were collected from January 20103 to February 2017 in our hospital.All the patients wre divided into healing therapy group and death group according to the final results.And then the differences of clinical data of the two groups were analyed and compared by statistical methods.Results Age,comorbidities,Forrest classification,shock,blood clotting abnormalities,bleeding,bleed under gastroscopy titanium clips,endoscopic hemostasis proportion of drug and surgery to stop bleeding of cure group were lower than death group.The serum albumin levels of the cure group was significantly higher than death group.Multivariate analysis showed that the patients' age,complications and rebleeding were the independent risk factor for death of the patient with gastrointestinal bleeding uler.Conclusion Age,complications and rebleeding can cause patient with gastrointestinal bleeding uler died.The patients with gastrointestinal bleeding uler who are age,complications and rebleeding should give high priority in clinical work.
Objective To explore the risk factors affecting the living conditions of the pateints with gastrointestinal bleeding uler.Methods 345 cases gastrointestinal bleeding uler patients' clinical data were collected from January 20103 to February 2017 in our hospital.All the patients wre divided into healing therapy group and death group according to the final results.And then the differences of clinical data of the two groups were analyed and compared by statistical methods.Results Age,comorbidities,Forrest classification,shock,blood clotting abnormalities,bleeding,bleed under gastroscopy titanium clips,endoscopic hemostasis proportion of drug and surgery to stop bleeding of cure group were lower than death group.The serum albumin levels of the cure group was significantly higher than death group.Multivariate analysis showed that the patients' age,complications and rebleeding were the independent risk factor for death of the patient with gastrointestinal bleeding uler.Conclusion Age,complications and rebleeding can cause patient with gastrointestinal bleeding uler died.The patients with gastrointestinal bleeding uler who are age,complications and rebleeding should give high priority in clinical work.
引文
[1] 刘海琴.消化性溃疡并发出血的危险因素分析及干预对策[J].医学综述,2010,19(16):3 054-3 056.
[2] 吴春城,谢会忠.非甾体抗炎药和幽门螺杆菌感染对消化性溃疡并发出血的影响[J].中国全科医学,2010,13(8):824-826.
[3] 张丽娜,马治国,杨少奇.消化性溃疡出血死亡危险因素分析[J].中国消化杂志,2014,34(2):85-88.
[4] 中华内科杂志编委会,中华消化杂志编委会,中华消化内镜杂志编委会.急性非静脉曲张性上消化道出血诊治指南(2009,杭州)[J].中华消化杂志,2009,29(10):682-686.
[5] 陈国强,郭玉莲.内镜下金属肽夹治疗消化性溃疡急性出血50例临床观察[J].海南医学,2009,20(9):204-205.
[6] Cheng CL,Lin CH,Kuo CJ,et a1.Predictors of rebleeding and mortality in patients with high-risk bleeding peptic ulcers[J].Dig Dis Sci,2010,55(9):2 577-2 583.
[7] Chiu PW,Ng EK,Cheung FK,et a1.Predicting mortality in patients with bleeding peptic ulcers after therapeutic endoscopy[J].Clin Gastroenterol Hepatol,2009,7(3):311-316.
[8] Lau JY,Sung J,Hill C,et a1.Systematic review Of the epidemiology of complicated peptic ulcer disease:incidence,recurrence,risk factors and mortality[J].Digestion,201l,84(2):102-113.
[9] 石益海,张丽丽,钱家鸣,等.影响消化道出血患者预后的多因素分析[J].胃肠病和肝病学杂志,2008,17(9):720-722.
[10] Kapsoritakis AN,Ntounas EA,Makrigiannis EA,et a1.Acute upper gastrointestinal bleeding in central Greece:the role of clinical and endoscopic variables in bleeding outcome[J].Dig Dis Sci,2009,54(2):333-341.
[2] 吴春城,谢会忠.非甾体抗炎药和幽门螺杆菌感染对消化性溃疡并发出血的影响[J].中国全科医学,2010,13(8):824-826.
[3] 张丽娜,马治国,杨少奇.消化性溃疡出血死亡危险因素分析[J].中国消化杂志,2014,34(2):85-88.
[4] 中华内科杂志编委会,中华消化杂志编委会,中华消化内镜杂志编委会.急性非静脉曲张性上消化道出血诊治指南(2009,杭州)[J].中华消化杂志,2009,29(10):682-686.
[5] 陈国强,郭玉莲.内镜下金属肽夹治疗消化性溃疡急性出血50例临床观察[J].海南医学,2009,20(9):204-205.
[6] Cheng CL,Lin CH,Kuo CJ,et a1.Predictors of rebleeding and mortality in patients with high-risk bleeding peptic ulcers[J].Dig Dis Sci,2010,55(9):2 577-2 583.
[7] Chiu PW,Ng EK,Cheung FK,et a1.Predicting mortality in patients with bleeding peptic ulcers after therapeutic endoscopy[J].Clin Gastroenterol Hepatol,2009,7(3):311-316.
[8] Lau JY,Sung J,Hill C,et a1.Systematic review Of the epidemiology of complicated peptic ulcer disease:incidence,recurrence,risk factors and mortality[J].Digestion,201l,84(2):102-113.
[9] 石益海,张丽丽,钱家鸣,等.影响消化道出血患者预后的多因素分析[J].胃肠病和肝病学杂志,2008,17(9):720-722.
[10] Kapsoritakis AN,Ntounas EA,Makrigiannis EA,et a1.Acute upper gastrointestinal bleeding in central Greece:the role of clinical and endoscopic variables in bleeding outcome[J].Dig Dis Sci,2009,54(2):333-341.