胶囊内镜与临床评分系统对急性上消化道出血风险分层的对比研究

发布时间：2018-04-27 05:03

本文选题：Blatchford评分 + Rockall评分　；参考：《重庆医学》2015年08期

【摘要】：目的比较实时胶囊内镜(VCE)与Rockall和Blatchford评分系统对急性上消化道出血(AUGIB)风险分层的准确性。方法将24例急诊室AUGIB患者按照随机数字表法分为VCE组和对照组,每组各12例。所有患者均进行Rockall和Blatchford评分,并随后行24h内急诊胃镜(EGD)检查。对照组根据临床评分决定检查时机,VCE组则依VCE检查结果而定。根据Rockall和Blatchford评分,将24例患者分为高危、低危人群,并与VCE结果比较。结果 24例中13例具有EGD高危特征,中位Rockall和Blatchford评分分别为3、13分;另11例无EGD高危特征,中位Rockall及Blatchford评分分别为2、11分。组间Rockall评分(95%CI:2.2~0.3;P=0.12)及Blatchford评分(95%CI:5.2~1.4;P=0.23)比较差异均无统计学意义。亚组分析显示,12例中9例VCE检查呈阳性,且得到后续EGD检查证实;12例中3例VCE阴性患者亦无EGD高危特征。VCE与EGD检查结果一致(P=1.00)。结论 Rockall和Blatchford评分与EGD相关性差,VCE成为更好的风险分层工具。
[Abstract]:Objective to compare the accuracy of real-time capsule endoscopy and Rockall and Blatchford scoring system in the risk stratification of acute upper gastrointestinal hemorrhage. Methods 24 patients with AUGIB in emergency room were randomly divided into VCE group and control group with 12 cases in each group. All patients were assessed with Rockall and Blatchford, followed by emergency gastroscopy within 24 hours. In the control group, the time of examination was determined according to the clinical score. According to Rockall and Blatchford scores, 24 patients were divided into high risk and low risk groups, and compared with VCE results. Results among the 24 cases, 13 cases had high risk characteristics of EGD, the median Rockall and Blatchford scores were 3 and 13 respectively, while the other 11 cases had no high risk characteristics of EGD, the median Rockall and Blatchford scores were 2 and 11 respectively. There was no significant difference between the two groups in terms of Rockall score (95 CI: 2.2 / 0.3) and Blatchford score (95% CI: 5.2 / 1.4 / P0. 23). Subgroup analysis showed that 9 of 12 cases were positive for VCE, and 3 of 12 cases with negative VCE were confirmed by follow-up EGD examination. The results of VCE and EGD were consistent with those of EGD. Conclusion Rockall and Blatchford are better risk stratification tools with poor correlation with EGD.
【作者单位】：四川省成都市第七人民医院消化内科;
【分类号】：R573.2

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