111例胃Dieulafoy病出血临床特征及再出血危险因素分析

发布时间：2018-03-14 07:45

  本文选题：Dieulafoy病　切入点：临床特征　出处：《中国内镜杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的 Dieulafoy病是一种较少见的上消化道出血性疾病,该研究目的是认识胃Dieulafoy病临床特点及Dieulafoy病经治疗后再次出血的风险因素。方法回顾性研究2009年1月-2016年6月于南昌大学第一附属医院消化内镜中心经胃镜确诊为胃Dieulafoy病出血患者,分析患者的临床资料、内镜下特点及再出血危险因素。结果在111例患者中,男97例(87.4%);发病部位主要好发于胃底及高位胃体53例(47.7%),按Forrest分级主要为Ⅰ期52例(46.8%)及Ⅱ期58例(52.3%);主要以内镜联合药物治疗为主101例(91.0%),内镜治疗方法止血成功率为84.2%,单种内镜、两种内镜、三种内镜治疗方法的止血率分别为85.0%、84.8%、75.0%。对于101例行内镜联合药物治疗患者,胃底及高位胃体、中低位胃体、胃窦的止血成功率分别为83.7%、82.1%、88.9%。在111例上述观察指标中,年龄(P=0.002)和输血(P=0.004)在单因素分析中是再出血危险因素;在101例均已行内镜处理的Dieulafoy病出血的患者中,Logistic回归多因素分析,表明输血(P=0.018,OR=37.77,95%CI=1.86~766.47)为经治疗后再出血独立的危险因素。结论内镜治疗是一种有效的治疗方法,输血为经治疗后再出血独立的危险因素,各种内镜治疗方法无明显差异,出血部位不同在经治疗后再出血组与非再出血组间无明显差异。
[Abstract]:Objective Dieulafoy's disease is a rare hemorrhagic disease of upper digestive tract. The aim of this study was to understand the clinical features of gastric Dieulafoy's disease and the risk factors for rebleeding after treatment for Dieulafoy's disease. Methods A retrospective study was conducted from January 2009 to June 2016 in the endoscopy Center of Digestive Endoscopy, first affiliated Hospital of Nanchang University. Bleeding patients with gastric Dieulafoy's disease, The clinical data, endoscopic features and risk factors of rebleeding were analyzed. The main sites of the disease were 47.7% in the stomach fundus and 53 cases in the high stomach body, according to the Forrest classification, 52 cases had stage 鈪，

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