宋向奎

[摘要] 目的 探析急诊消化内科上消化道出血的治疗方案。方法 整群选择该院消化内科2014年2月—2015年2月收治89例上消化道出血急诊患者展开研究，随机分为两组。两组视实际情况采取综合治疗，观察组在对照组基础上口服云南白药，比较两组治疗有效率、不良反应发生率。 结果 观察组治疗有效率为95.6%，高于对照组72.7%，比较差异有统计学意义（P<0.05）。两组不良反应发生率的比较，差异无统计学意义（P>0.05）。结论 药物保守治疗与消化性溃疡穿孔术治疗急诊上消化道出血均有较好效果，结合患者病情确定治疗方法即可，在此基础上加用云南白药可进一步强化止血效果，安全性高，值得推广。

[关键词] 急诊；上消化道出血；止血；胃酸；胃黏膜

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）09（b）-0017-02

[Abstract] Objective To explore the treatment plan of upper gastrointestinal hemorrhage in emergency department of gastroenterology. Methods 89 patients with upper gastrointestinal hemorrhage admitted into the emergency department of gastroenterology of the hospital from February 2014 to February 2015 were studied and randomly divided into two groups. Both of the two groups received comprehensive treatment depending on the actual situation. The observation group orally took Yunnan Baiyao on the basis of the treatment of the control group. The treatment efficiency and the incidence of adverse reactions of the two groups were compared. Results The effective rate of the observation group was 95.6% which was higher than72.7% of the control group and the comparison was statistically significant （P<0.05）. The comparison of incidence of adverse reactions between the two groups was not statistically significant （P>0.05）. Conclusion The curative effects of both drug conservative treatment and peptic ulcer perforation surgery in the treatment of acute upper gastrointestinal hemorrhage are good. According to patient condition， the treatment method can be determined and based on this， adopting Yunnan Baiyao can further strengthen hemostatic effect and is of high safety which is worthy to be popularized.

[Key words] Emergency； Upper gastrointestinal hemorrhage； Hemostasis； Gastric acid； Gastric mucosa

上消化道出血主要指以屈氏韧带上方的胰脏、胆、消化道等部位的出血症状，通常为空肠吻合术病变所致。该病病因较多，以急性胃黏膜、消化性溃疡较为常见，患者多出现呕血、黑便等临床症状[1-2]。该研究以该院2014年2月—2015年2月收治的89例上消化道出血急诊患者作为研究对象，对急诊消化内科上消化道出血的治疗方案进行探析，现报道如下。

1 资料与方法

1.1 一般资料

整群选择该院消化内科收治89例上消化道出血急诊患者展开研究，随机数字表法分为观察组（n=45）与对照组（n=44）。观察组男女比例27：18，年龄26～63岁，平均（42.2±7.4）岁。发病到就诊时间在2～8 h，平均（4.2±0.7） h。20例出血性胃炎、11例为消化性溃疡、9例为复合性溃疡、4例为胃癌出血、1例为原因不明出血。对照组男女比例28：16，年龄24～66岁，平均（42.4±7.6）岁。……