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目的 寻找影响消化性溃疡并出血的预后的各项因素 ,以指导临床个体化治疗方案的选择。方法 设年龄、吸烟、饮酒、腹痛程度、发病时间、首次出血年龄、出血来源、出血部位、出血方式、出血量 (血色素 )、休克、内镜表现、伴随疾病数、伴随疾病严重性、服药 (NSAIDs)史、治疗手段 (药物、内镜、手术 )为可能影响预后的因素 ;设治愈、再出血、急症手术、死亡为转归结果 ;对 5 88例消化性溃疡并出血的患者进行Logistic逐步回归分析。结果 出血部位位于胃底、内镜下有活动性出血表现及内镜介入止血治疗与再出血有显著性关系 ;内镜下有活动性出血表现及内镜介入止血治疗与急性手术有显著性关系 ;高龄、休克、有严重伴随疾病、内镜下有活动性出血表现与死亡有显著性关系。结论 高龄、有休克表现、胃底出血以及内镜下有活动性出血表现、有严重的伴随疾病是消化性溃疡并出血的高危因素 ,对此类病人 ,尽早内镜治疗和手术治疗可改善预后 ,减少再出血 ,减低手术率和死亡率。
Objective To find the factors influencing the prognosis of peptic ulcer and bleeding to guide the choice of clinical individualized treatment. Methods The age, smoking, alcohol consumption, degree of abdominal pain, onset time, first bleeding age, source of bleeding, site of bleeding, mode of bleeding, amount of bleeding (hemoglobin), shock, endoscopic findings, number of accompanying diseases, NSAIDs) history, treatment (drugs, endoscopy, surgery) as factors that may affect the prognosis; cure, rebleeding, emergency surgery, death as the outcome; 5 88 cases of peptic ulcer and bleeding patients Logistic step by step regression analysis. Results The bleeding sites were located in the fundus, active bleeding under endoscopy and endoscopic interventional hemostasis were significantly associated with rebleeding; endoscopic active bleeding and endoscopic interventional hemostasis were significantly associated with acute surgery ; Elderly, shock, with serious accompanying disease, endoscopic active bleeding and death have a significant relationship. Conclusion The elderly, with shock performance, gastric fundus bleeding and endoscopic active bleeding, there is a serious companion disease is peptic ulcer and bleeding risk factors for such patients, early endoscopic treatment and surgical treatment can improve the prognosis , Reduce rebleeding, reduce the surgical rate and mortality.