预测在下胃肠道出血时需要紧急内镜干预的需要:回顾性审查
Barzany Ridha1, Nigel Hey2, Lauren Ritchie2
1Department of Emergency Medicine, College of Medicine, University of Saskatchewan, Royal University Hospital, 104 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada. kvz371@usask.ca.
血红蛋白显著下降预示着在下胃肠道出血 (LGIB) 患者中需要紧急内镜干预. 这一发现有助于识别需要立即内镜评估的高风险个体.
科学领域:
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 下胃肠道出血 (LGIB) 经常导致急诊室的访问和住院.
- 新出现的证据表明,对于低风险的LGIB患者,门诊评估可能是安全的.
- 缺乏标准化标准来识别低风险的LGIB患者进行门诊治疗.
研究的目的:
- 确定与需要紧急内镜干预下部胃肠道出血 (LGIB) 相关的患者预测因素.
- 为了确定LGIB患者向急诊室呈现的风险分层标准.
主要方法:
- 对142名LGIB患者的回顾性图表审查.
- 数据收集包括人口统计,临床特征,并发病,药物,血液动力学,实验室和成像.
- 统计分析包括后勤回归,t测试,曼·惠特尼U和Chi平方测试.
主要成果:
- 血红蛋白下降大于20g/L是内镜干预的唯一显著预测因素 (p=0.030).
- 慢心,低血压和抗凝药的使用与干预的必要性没有显著关联 (p>0.05).
结论:
- 血红蛋白下降超过20g/L是唯一确定的患者参数,预测需要紧急内镜干预在LGIB的急诊室设置.
- 这一发现可以帮助早期识别需要立即内镜手术的LGIB患者.
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