Botianu Am, Matei D, Tantau M, Acalovschi M
University of Medicine and Pharmacy, Cluj Napoca, Romania.
Chirurgia (Bucur). 2013 May-Jun;108(3):312-8.
Acute upper gastrointestinal bleeding, previously often a surgical problem, is now the most common gastroenterological emergency.
To evaluate the current situation in terms of mortality and need of surgery.
Retrospective non-randomised clinical study performed between 1st January-31st December 2011, at "Professor Dr. Octavian Fodor" Regional Institute of Gastroenterology and Hepatology in Cluj Napoca. 757 patients with upper gastrointestinal bleeding were endoscopically examined within 24 hours from presentation in the emergency unit. Data were collected from admission charts and Hospital Manager programme. Statistical analysis was performed with GraphPad 2004, using the following tests: chi square, Spearman, Kruskall-Wallis, Mann-Whitney, area under receiver operating curve.
Non-variceal etiology was predominant, the main cause was bleeding being peptic ulcer. In hospital global mortality was of 10.43%, global rebleeding rate was 12.02%, surgery was performed in 7.66% of patients. Urgent haemostatic surgery was needed in 3.68% of patients with nonvariceal bleeding. The need for surgery correlated with the postendoscopic Rockall score (p=0.0425). In peptic ulcer, the need for surgery was not influenced by time to endoscopy or type of treatment (p=0.1452). Weekend (p=0.996) or night (p=0.5414) admission were not correlated with a higher need for surgery.
Over the last decade, the need for urgent surgery in upper gastrointestinal bleeding has decreased by half, but mortality has remained unchanged.
急性上消化道出血以前常常是一个外科问题，现在是最常见的胃肠急症。
评估死亡率和手术需求方面的现状。
2011年1月1日至12月31日在克卢日-纳波卡的“奥克塔维安·福多尔教授”地区胃肠病学和肝病研究所进行的回顾性非随机临床研究。757例上消化道出血患者在急诊室就诊后24小时内接受了内镜检查。数据从入院病历和医院管理程序中收集。使用GraphPad 2004进行统计分析，采用以下检验：卡方检验、斯皮尔曼检验、克鲁斯卡尔-沃利斯检验、曼-惠特尼检验、受试者操作特征曲线下面积。
非静脉曲张病因占主导，主要出血原因是消化性溃疡。医院总体死亡率为10.43%，总体再出血率为12.02%，7.66%的患者接受了手术。3.68%的非静脉曲张出血患者需要紧急止血手术。手术需求与内镜检查后罗卡尔评分相关（p = 0.0425）。在消化性溃疡中，手术需求不受内镜检查时间或治疗类型的影响（p = 0.1452）。周末（p = 0.996）或夜间（p = 0.5414）入院与更高的手术需求无关。
在过去十年中，上消化道出血紧急手术的需求减少了一半，但死亡率保持不变。
