探讨不同性别非静脉曲张上消化道出血在重症病房的临床特点
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摘要
目的探讨不同性别非静脉曲张上消化道出血(non variceal upper gastrointestinal bleeding,NVUGIB)在重症病房的临床特点。方法回顾性分析2015-2017年入住我院重症监护室的NVUGIB患者100例。所有患者严格按照Glasgow-Blatchford(GBS)评分进行筛选。按性别分组,并比较两组患者的临床特点及预后差异。结果 NVUGIB重症病房中常见病因为消化性溃疡,且性别差异有统计学意义(P <0. 05);生命体征方面,男性组血压、血红蛋白及心率均较女性组差,差异有统计学意义(P <0. 05);男性组合并基础疾病患者比率较女性组高,差异有统计学意义(P <0. 05);男性组远期预后差且死亡率较女性组高,差异有统计学意义(P <0. 05)。结论 NVUGIB重症病房中常见病因为消化性溃疡,且男性在生命体征(心率、血红蛋白)、基础疾病及远期预后方面均差于女性。
Objective To investigate the clinical features of non variceal upper gastrointestinal bleeding( NVUGIB)with different genders in intensive care unit. Methods One hundred cases of NVUGIB in the intensive care unit of our hospital from 2015 to 2017 were analyzed retrospectively. All patients were screened in strict accordance with Glasgow Blatchford score( GBS). Grouping by gender,clinical characteristics and prognosis were compared between two groups.Results The common diseases in the NVUGIB in intensive care unit were due to peptic ulcer,and the gender difference was statistically significant( P < 0. 05). Vital signs,blood pressure,hemoglobin and heart rate were lower in male than those in female group,and the difference was statistically significant( P < 0. 05). The ratio of basal disease in male group was higher than that in female group,and the difference was statistically significant( P < 0. 05). The longterm prognosis of the male group was poor and the mortality was higher than that of the female group,and the difference was statistically significant( P < 0. 05). Conclusion Common diseases in the NVUGIB in intensive care unit were due to peptic ulcer. Male groups were poorer in vital signs( heart rate,hemoglobin),basic diseases and prognosis than those in female group.
Objective To investigate the clinical features of non variceal upper gastrointestinal bleeding( NVUGIB)with different genders in intensive care unit. Methods One hundred cases of NVUGIB in the intensive care unit of our hospital from 2015 to 2017 were analyzed retrospectively. All patients were screened in strict accordance with Glasgow Blatchford score( GBS). Grouping by gender,clinical characteristics and prognosis were compared between two groups.Results The common diseases in the NVUGIB in intensive care unit were due to peptic ulcer,and the gender difference was statistically significant( P < 0. 05). Vital signs,blood pressure,hemoglobin and heart rate were lower in male than those in female group,and the difference was statistically significant( P < 0. 05). The ratio of basal disease in male group was higher than that in female group,and the difference was statistically significant( P < 0. 05). The longterm prognosis of the male group was poor and the mortality was higher than that of the female group,and the difference was statistically significant( P < 0. 05). Conclusion Common diseases in the NVUGIB in intensive care unit were due to peptic ulcer. Male groups were poorer in vital signs( heart rate,hemoglobin),basic diseases and prognosis than those in female group.
引文
[1]苟菊花,张秉强.急性非静脉曲张上消化道出血的内镜治疗[J].胃肠病学和肝病学杂志,2016,25(7):825-827. DOI:10. 3969/j.issn. 1006-5709. 2016. 07. 026.GOU J H,ZHANG B Q. Endoscopy hemostasis therapy for acute nonvariceal upper gastrointestinal bleeding[J]. Chin J Gastroenterol Hepatol,2016,25(7):825-827. DOI:10. 3969/j. issn. 1006-5709.2016. 07. 026.
[2] BAI Y,LI Z S. Guidelines for the diagnosis and treatment of acute nonvariceal upper gastrointestinal bleeding(2015,Nanchang,China)[J]. J Dig Dis,2016,17(2):79-87. DOI:10. 1111/1751-2980. 12319.
[3]中华医学会消化内镜学分会.急性非静脉曲张性上消化道出血诊治指南(2015年,南昌)[J].中华医学杂志,2016,96(4):254-259. DOI:10. 3760/cma. j. issn. 0376-2491. 2016. 04. 005.
[4] Indonesian Society of Gastroenterology. National consensus on management of non-variceal upper gastrointestinal tract bleeding in Indonesia[J]. Acta Med Indones,2014,46(2):163-171.
[5] GRALNEK I M,DUMONCEAU J M,KUIPERS E J,et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage:European Society of Gastrointestinal Endoscopy(ESGE)Guideline[J]. Endoscopy,2015,47(10):a1-a46. DOI:10. 1055/s-0034-1393172.
[6] GARBER A,JANG S. Novel therapeutic strategies in the management of non-variceal upper gastrointestinal bleeding[J]. Clin Endosc,2016,49(5):421-424. DOI:10. 5946/ce. 2016. 110.
[7] DRAGO F,MONTONERI C,VARGA C,et al. Dual effect of female sex steroids on drug-induced gastroduodenal ulcers in the rat[J]. Life Sci,1999,64(25):2341-2350.
[8] BARKUN A N,BARDOU M,KUIPERS E J,et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding[J]. Ann Intern Med,2010,152(2):101-113. DOI:10. 7326/0003-4819-152-2-201001190-00009.
[9] ZHANG P,GUO R,LI Z,et al. Effect of smoking on common carotid artery wall elasticity evaluated by echo tracking technique[J].Ultrasound Med Biol,2014,40(3):643-649. DOI:10. 1016/j. ultrasmedbio. 2013. 10. 009.
[10] GINTY A T,CARROLL D,ROSEBOOM T J,et al. Depression and anxiety are associated with a diagnosis of hypertension 5 years later in a cohort of late middle-aged men and women[J]. J Hum Hypertens,2013,27(3):187-190. DOI:10. 1038/jhh. 2012. 18.
[11] HILDRETH K L,KOHRT W M,MOREAU K L. Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition[J]. Menopause,2014,21(6):624-632.DOI:10. 1097/GME. 0000000000000116.
[12]邹多武.亚太地区非静脉曲张性上消化道出血专家共识意见解读(四):24小时内的内镜干预能够改善高危患者的预后[J].中华消化杂志,2012,32(2):83-84. DOI:10. 3760/cma. j. issn.0254-1432. 2012. 02. 003.
[13] VILLANUEVA C,COLOMO A,BOSCH A,et al. Transfusion strategies for acute upper gastrointestinal bleeding[J]. N Engl J Med,2013,368(1):11-21. DOI:10. 1056/NEJMoa1211801.
[14] SUNG J J,CHAN F K,CHEN M,et al. Asia-Pacific Working Group consensus on non-variceal upper gastrointestinal bleeding[J]. Gut,2011,60(9):1170-1177. DOI:10. 1136/gut. 2010. 230292.
[15] SZURA M,PASTERNAK A. Upper non-variceal gastrointestinal bleeding-review the effectiveness of endoscopic hemostasis methods[J]. World J Gastrointest Endosc,2015,7(13):1088-1095. DOI:10. 4253/wjge.v7. i13. 1088.
[2] BAI Y,LI Z S. Guidelines for the diagnosis and treatment of acute nonvariceal upper gastrointestinal bleeding(2015,Nanchang,China)[J]. J Dig Dis,2016,17(2):79-87. DOI:10. 1111/1751-2980. 12319.
[3]中华医学会消化内镜学分会.急性非静脉曲张性上消化道出血诊治指南(2015年,南昌)[J].中华医学杂志,2016,96(4):254-259. DOI:10. 3760/cma. j. issn. 0376-2491. 2016. 04. 005.
[4] Indonesian Society of Gastroenterology. National consensus on management of non-variceal upper gastrointestinal tract bleeding in Indonesia[J]. Acta Med Indones,2014,46(2):163-171.
[5] GRALNEK I M,DUMONCEAU J M,KUIPERS E J,et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage:European Society of Gastrointestinal Endoscopy(ESGE)Guideline[J]. Endoscopy,2015,47(10):a1-a46. DOI:10. 1055/s-0034-1393172.
[6] GARBER A,JANG S. Novel therapeutic strategies in the management of non-variceal upper gastrointestinal bleeding[J]. Clin Endosc,2016,49(5):421-424. DOI:10. 5946/ce. 2016. 110.
[7] DRAGO F,MONTONERI C,VARGA C,et al. Dual effect of female sex steroids on drug-induced gastroduodenal ulcers in the rat[J]. Life Sci,1999,64(25):2341-2350.
[8] BARKUN A N,BARDOU M,KUIPERS E J,et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding[J]. Ann Intern Med,2010,152(2):101-113. DOI:10. 7326/0003-4819-152-2-201001190-00009.
[9] ZHANG P,GUO R,LI Z,et al. Effect of smoking on common carotid artery wall elasticity evaluated by echo tracking technique[J].Ultrasound Med Biol,2014,40(3):643-649. DOI:10. 1016/j. ultrasmedbio. 2013. 10. 009.
[10] GINTY A T,CARROLL D,ROSEBOOM T J,et al. Depression and anxiety are associated with a diagnosis of hypertension 5 years later in a cohort of late middle-aged men and women[J]. J Hum Hypertens,2013,27(3):187-190. DOI:10. 1038/jhh. 2012. 18.
[11] HILDRETH K L,KOHRT W M,MOREAU K L. Oxidative stress contributes to large elastic arterial stiffening across the stages of the menopausal transition[J]. Menopause,2014,21(6):624-632.DOI:10. 1097/GME. 0000000000000116.
[12]邹多武.亚太地区非静脉曲张性上消化道出血专家共识意见解读(四):24小时内的内镜干预能够改善高危患者的预后[J].中华消化杂志,2012,32(2):83-84. DOI:10. 3760/cma. j. issn.0254-1432. 2012. 02. 003.
[13] VILLANUEVA C,COLOMO A,BOSCH A,et al. Transfusion strategies for acute upper gastrointestinal bleeding[J]. N Engl J Med,2013,368(1):11-21. DOI:10. 1056/NEJMoa1211801.
[14] SUNG J J,CHAN F K,CHEN M,et al. Asia-Pacific Working Group consensus on non-variceal upper gastrointestinal bleeding[J]. Gut,2011,60(9):1170-1177. DOI:10. 1136/gut. 2010. 230292.
[15] SZURA M,PASTERNAK A. Upper non-variceal gastrointestinal bleeding-review the effectiveness of endoscopic hemostasis methods[J]. World J Gastrointest Endosc,2015,7(13):1088-1095. DOI:10. 4253/wjge.v7. i13. 1088.