【摘要】 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。更多还原

【Abstract】 During the period from Oct. 1979 through Feb. 1981, emergency endoscopy was done for acute upper gastrointestinal hemorrhage in 140 cases. Positive diagnosis was 92.8 %. Among them active or recent bleeding lesions were seen in 120 cases(85.7%). The detective rate for bleeding lesions was 93.9% within 24 hours, and 74.1% in 24-48 hours 17.8% of patients had more than one bleeding lesions. The primary causes of bleeding were peptic ulcer (34.3%), acute mucosal lesions (26.4%), carcinoma of the stomach (17.1%), chronic gastritis (8.6%) and esophageal varices (2.1%). The endoscopic diagnosis coincided with barium meal radiography in 85 of 115 cases(73.9%), the diagnostic value of emergency endoscopy for various gastritis, peptic ulcer and gastric cancer, especially for acute mucosal lesion, was more sensitive than that of x-ray.Fifty active bleeders were managed by endoscopic local hemostasis. The efficacy of Monsell’s solution or adona was more than 80 per cent. Rebleeding occurred in 4 cases (2.8%), but none died of complications during endoscopy. An erroneous diagnosis was made in 6 patients (4.3%). Therefore emergency endoscopy is a safe, reliable and highly efficacious diagnostic procedure. It could provide a reliable guide for proper treatment and should be done as soon as there is indication.更多还原