Klein Amir, Gralnek Ian M
aBruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology bDepartment of Gastroenterology, Rambam Healthcare Campus, Haifa cDepartment of Gastroenterology, Ha'Emek Medical Center, Afula, Israel.
Curr Opin Crit Care. 2015 Apr;21(2):154-62. doi: 10.1097/MCC.0000000000000185.
Acute, nonvariceal upper gastrointestinal bleeding (UGIB) is a common medical emergency encountered worldwide. Despite medical and technological advances, it remains associated with significant morbidity and mortality.
Rapid patient assessment and management are paramount. When indicated, upper endoscopy in patients presenting with acute UGIB is effective for both diagnosis of the bleeding site and provision of endoscopic hemostasis. Endoscopic hemostasis significantly reduces rebleeding rates, blood transfusion requirements, length of hospital stay, surgery, and mortality. Furthermore, early upper endoscopy, defined as being performed within 24 h of patient presentation, improves patient outcomes.
A structured approach to the patient with acute UGIB that includes early hemodynamic resuscitation and stabilization, preendoscopic risk stratification using validated instruments, pharmacologic and endoscopic intervention, and postendoscopy therapy is important to optimize patient outcome and assure efficient use of medical resources.
急性非静脉曲张性上消化道出血（UGIB）是全球范围内常见的医疗急症。尽管医学和技术不断进步，但它仍然与显著的发病率和死亡率相关。
对患者进行快速评估和管理至关重要。在有指征时，对急性UGIB患者进行上消化道内镜检查对于出血部位的诊断和内镜止血均有效。内镜止血可显著降低再出血率、输血需求、住院时间、手术率和死亡率。此外，早期上消化道内镜检查（定义为在患者就诊后24小时内进行）可改善患者预后。
对于急性UGIB患者，采用结构化方法，包括早期血流动力学复苏和稳定、使用经过验证的工具进行内镜检查前风险分层、药物和内镜干预以及内镜检查后治疗，对于优化患者预后和确保有效利用医疗资源非常重要。
