急性上消化道大出血多学科协作治疗体会

伍德生; 王小玲; 齐本权; 郭晋; 潘莉; 王方莉; 吴晓飞

doi:10.13898/j.cnki.issn.1000-2200.2020.12.011

急性上消化道大出血多学科协作治疗体会

Experience of multidisciplinary collaboration in the treatment of acute upper gastrointestinal massive hemorrhage

摘要

摘要:
目的观察多学科协作治疗急性上消化道大出血的效果。
方法选择2016年11月至2017年11月接受传统治疗方式的急性上消化道大出血病人78例作为对照组，2017年12月至2018年12月接受多学科协作治疗模式的80例病人为观察组。按照多学科协作治疗模式以急诊内科为中心，利用急诊重症监护病房给予严密监护、液体复苏及呼吸支持等抢救措施，同时启动包括消化内镜、介入和外科在内的多学科协作模式。分析2组病例特征、治愈率、死亡率、平均住院时间等指标。
结果对照组止血成功62例，治愈率79.49%，观察组止血成功73例，治愈率91.25%，2组间比较差异有统计学意义（P < 0.05）。对照组的平均住院时间（16.95±7.33）d长于观察组的（13.50±8.81）d（P < 0.05）。
结论进行多学科协作治疗有助于提高病人的救治成功率，缩短平均住院时间，改善病人的预后。

Abstract:
ObjectiveTo observe the therapeutic effects of multidisciplinary collaboration in the treatment of acute upper gastrointestinal massive hemorrhage.
MethodsSeventy-eight patients with acute upper gastrointestinal massive hemorrhage treated with traditional method from November 2016 to November 2017 were set as the control group, and 80 patients treated with multidisciplinary cooperation from December 2017 to December 2018 were set as the observation group.According to the multidisciplinary cooperation treatment model, the emergency department was the center, the intensive care, fluid resuscitation, respiratory support and other rescue measures were provided by the emergency intensive care unit and the multidisciplinary cooperation mode(including the digestive endoscopy, intervention and surgery)was implemented simutaneously.The case characteristics, cure rate, mortality rate and average length of hospital stay in two groups were analyzed.
ResultsIn the control group, there were 62 cases of successful hemostasis, and the cure rate was 79.49%.In the observation group, there were 73 cases of successful hemostasis, and the cure rate was 91.25%.The differences of the successful hemostasis and cure rate were statistically significant(P < 0.05).The mean length of hospital stay in control group(16.95±7.33)d was longer than that in observation group(13.50±8.81)d(P < 0.05).
ConclusionsMultidisciplinary collaboration therapy can improve the survival rate of patients, shorten the average length of hospital stay, and improve the prognosis of patients.

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