李强

[摘要] 目的 觀察急性胃出血采取急诊治疗的临床效果。方法 便利收集自2018年5月—2019年5月时间段该院急诊科接治的72例患者为急性胃出血的患者开展研究，以就诊顺序与患者需求分为单一组（n=36）和治疗组（n=36），对单一组36例患者采取保守药物诊疗，治疗组36例患者基于保守治疗前提下采取急诊内镜下止血，对比两组治疗效果、出血控制时间与住院时间及生活质量（心理功能、生理功能和社会领域、总健康活力及躯体能力）。结果 通过治疗后，治疗组的总有效率94.44%较单一组的总有效率77.78%升高效果明显（χ2=4.181，P<0.05）;治疗组出血控制时间（2.80±0.85）min与住院时间（6.69±1.18）d相比较单一组明显较短，两组差异有统计学意义（t=11.764、8.819，P<0.05）;采用生活健康量表评价72例患者生活质量，结果显示，治疗组在心理功能（80.01±5.25）分、生理功能（81.12±5.02）分和社会领域（80.01±2.18）分、总健康活力（82.31±4.56）分及躯体能力（83.14±2.24）分与单一组比较改善效果显著，差异有统计学意义（t=9.762、11.054、14.388、15.478、21.288，P<0.05）。结论 急性胃出血采取胃镜下止血和药物协同治疗效果理想，可有效缩短出血时间与住院时间，缓解临床症状，对患者生活质量具有积极作用，是一种值得临床应用与推广的治疗措施。

[关键词] 急性胃出血;保守治疗;生活质量;胃镜下止血;效果

[Abstract] Objective To observe the Emergency clinical effect of emergency treatment for acute gastric bleeding. Methods A total of 72 patients who were convenient treated in the clinic from May 2018 to May 2019 were studied for acute gastric bleeding. The order of consultation and patient needs was divided into a single group （n=36） and a treatment group （n=36）， 36 patients in a single group were treated with conservative medicine， and 36 patients in the treatment group were treated with emergency endoscopic hemostasis based on conservative treatment. The treatment effects， bleeding control time， hospital stay， and quality of life were compared between the two groups （psychological function， physical function and social sphere， total health， vitality and physical ability）. Results After passing the treatment， the total effective rate of the treatment group was 94.44%， which was significantly higher than the total effective rate of 77.78% in the single group （χ2=4.181， P<0.05）; bleeding control time （2.80±0.85） min and hospital stay time （ 6.69±1.18） d is significantly shorter than the single group， and the difference between the two groups is statistically significant （t=11.764， 8.818， P<0.05）; the quality of life of 72 patients was evaluated using the life health scale， and the results showed that the treatment group was in The scores of psychological function （80.01±5.25）points， physiological function （81.12±5.02）points， social field （80.01±2.18）points， total health and vitality （82.31±4.56）points， and physical ability （83.14±2.24）points were improved compared with the single group. The effect was significant and the difference was statistically significant （t=9.762， 11.054， 14.388， 15.478， 21.288，P<0.05）. Conclusion Gastroscopic hemostasis and drug synergistic treatment with acute gastric hemorrhage have ideal effects， can effectively reduce bleeding time and hospitalization time， relieve clinical symptoms， and have a positive effect on patients' quality of life. It is a treatment measure worthy of clinical application and promotion.

[Key words] Acute gastric bleeding; Conservative treatment; Quality of life; Hemostasis under gastroscopy; Effect

急性胃出血是当前临床常见的急诊病症，归属消化系统疾病范畴，临床实践资料表明[1]，急性胃出血致病主要因子多与慢性胃溃疡、食管黏膜破裂及应激性胃溃疡、老年萎缩性胃炎有关，且相关报道指出[2]，胃出血常见于冬春两季，多以呕血、黑便为临床症状，同时伴有发热和腹痛、出血迹象，出血严重时可致患者休克，对患者身心造成伤害，甚至伤及生命。针对急性胃出血患者，建议急诊治疗，但因患者临床症状不一，有个别患者初发症状不明显，为此，对急性胃出血患者迅速诊断和积极治疗是当前急诊治疗的基本准则。该研究为进一步探析不同诊疗措施对急性胃出血的临床效果，对2018年5月—2019年5月时间段该急诊科的72例患者实施分组比较治疗，以期获取良效。报道如下。

1  资料与方法

1.1  一般资料

便利收集该院急诊科接治的72例患者为急性胃出血的患者开展研究。……