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目的:探讨成立紧急医疗救护小组(MET)在急诊胃镜诊治上消化大出血患者中的临床价值。方法:回顾性分析2014-09-2015-02我院启动MET救治的49例静脉曲张性上消化道大出血患者的临床资料,其中30例采用食管静脉曲张(EV)套扎联合胃底静脉组织胶注射,10例采用胃底组织胶注射,9例采用EV套扎。结果:成立MET后患者就诊至开始内镜治疗的平均时间为(43±21)min,术后ICU观察时间(32±9)h,1例于术后24h内死亡,1例于术后2周再出血死亡,急诊内镜止血有效率98%(48/49),49例均成功进行了内镜下治疗,有效率为96%(47/49),术中食管血栓头破裂大出血3例,注射硬化剂治疗后成功止血,术后未见严重并发症。结论:成立MET可实现静脉曲张性上消化道大出血迅速止血,对降低病死率和并发症发生率有着重要的临床意义,值得在临床推广应用。
Objective: To explore the clinical value of setting up Emergency Medical Ambulance Group (MET) in patients with digestive hemorrhage during emergency endoscopy diagnosis and treatment. Methods: The clinical data of 49 patients with variceal upper gastrointestinal bleeding who underwent MET treatment in our hospital from 2014-09-2015-02 were retrospectively analyzed. Among them, 30 patients underwent esophageal varices (EV) ligation combined with gastric venous tissue glue 10 cases were injected with gastric fundus, and 9 cases were ligated with EV. Results: The average time from the initiation of endoscopic treatment to the beginning of endoscopic therapy was (43 ± 21) min after ICU was established. The ICU observation time was 32 ± 9 h after the establishment of MET. One patient died within 24 h after operation, Weekly hemorrhage death, emergency endoscopic hemostasis effective rate 98% (48/49), 49 cases were successfully under endoscopic treatment, the effective rate was 96% (47/49), intraoperative esophageal thrombus rupture bleeding in 3 cases , Injection of sclerotherapy after hemostasis, no serious complications after surgery. Conclusion: The establishment of MET can achieve rapid hemostasis of varicose upper gastrointestinal hemorrhage, which has important clinical significance in reducing mortality and complication rate, and is worthy of clinical application.