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对140例急性上消化道出血患者进行了紧急内窥镜检查(简称镜检),130例(92.8％)被发现出血病灶,其中120例(85.7％)见有活动性出血或近期出血。24小时内镜检者,出血病灶发现率为93.9％,24～48小时为74.1％。25例(17.8％)见有二个出血病灶。引起出血的主要病因有消化性溃疡(34.3％)、急性粘膜病变(26.4％)、胃癌(17.1％)和慢性胃炎(8.6％)。另10例(7.1％)出血原因不明。镜检对各种出血原因的诊断价值优于钡餐检查。4例(2.8％)于镜检后再度出血,但无一例因镜检而死亡。误诊和漏诊共6例(4.3％)。紧急内窥镜检查安全、可靠、确诊率高,有助于及早采取合理的治疗和减少不必要的手术探查。
Emergency endoscopy was performed in 140 patients with acute upper gastrointestinal bleeding (microscopic examination). Bleeding was detected in 130 patients (92.8%), of which 120 (85.7%) had active bleeding or recent bleeding. Within 24 hours of microscopic examination, the detection rate of hemorrhagic lesions was 93.9% and 74.1% in 24-48 hours. Twenty-five patients (17.8%) had two hemorrhagic lesions. Peptic ulcers (34.3%), acute mucosal lesions (26.4%), gastric cancer (17.1%) and chronic gastritis (8.6%) were the major causes of bleeding. The other 10 cases (7.1%) had unknown cause of bleeding. Microscopic examination of the causes of various bleeding diagnosis is better than barium meal examination. Four patients (2.8%) had hemorrhage again after microscopy, but none of them died of microscopic examination. Misdiagnosis and missed a total of 6 cases (4.3%). Emergency endoscopy is safe, reliable and has a high rate of diagnosis, helping to take reasonable early treatment and reduce unnecessary surgical exploration.