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目的探讨急诊胃镜在诊治急性非静脉曲张性上消化道大出血中的经济价值。方法对2003-01-01—2007-12-31因呕血、黑便收入中山大学附属第三医院的急性非静脉曲张性上消化道出血患者作回顾性研究。比较急诊胃镜和择期胃镜各危险组之间在住院时间、住院费用、静脉使用质子泵抑制剂(PPI)时间和输血量等反映医疗资源利用的指标。结果共统计符合入选标准的患者332例,男性246例,女性86例。年龄平均(45.9±18.8)岁。急诊组171例、择期组161例。高危组中行急诊胃镜的患者和行择期胃镜的患者相比,除住院时间外,住院费用、输血量、静脉使用PPI时间等指标的差异均无统计学意义,在中危组和低危组中,4项指标差异均有统计学意义。结论对于Rockall评分<5分的患者,行急诊胃镜能够减少住院时间、住院费用、输血量和静脉使用PPI时间,对于Rockall评分≥5分的患者,急诊胃镜对住院费用、输血量、静脉使用PPI时间的影响需要进一步研究。
Objective To explore the economic value of emergency endoscopy in the diagnosis and treatment of acute non-variceal upper gastrointestinal hemorrhage. Methods A retrospective study was conducted on patients with acute non-variceal upper gastrointestinal hemorrhage who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2003 to January 2007 with a mean of 23 from 2003. The indicators reflecting the utilization of medical resources such as hospitalization time, cost of hospitalization, time of intravenous proton pump inhibitor (PPI) and blood transfusion were compared between emergency group and emergency group with gastroscopy. Results A total of 332 patients met the inclusion criteria, including 246 males and 86 females. The average age (45.9 ± 18.8) years old. 171 cases in emergency group and 161 cases in elective group. In high-risk group, there was no significant difference in hospitalization costs, blood transfusion volume and PPI time between intravenous administration and other patients who underwent emergency endoscopy compared with patients undergoing elective gastroscopy. , Four indicators were statistically significant differences. Conclusions Emergency endoscopy reduces hospital stay, hospitalization costs, blood transfusions, and intravenous PPI for patients with a Rockall score of <5, and emergency endoscopy for hospitalization costs, transfusions, intravenous PPI The impact of time needs further study.