Oshita Y, Okazaki Y, Takemoto T, Kawai K
Endoscopy. 1986 May;18 Suppl 2:11-4. doi: 10.1055/s-2007-1018419.
Hematemesis, melena, shock, vague symptoms, anemia, blood examinations and endoscopic findings are reviewed as signs of recent hemorrhage. An assessment of the condition of patients with upper GI bleeding is important for planning treatment. Therefore, in order to be able to evaluate a method of treatment of GI bleeding, reports referring to treatment of GI bleeding must contain a clear record of the severity of the patient's state and of the bleeding source. A common criterion for massive bleeding has been proposed. Specifically, a patient suffering from shock who needs more than 1,000 ml of blood or plasma expander by rapid transfusion within one hour, or more than 2,000 ml within the initial 24 hours, to stabilize his circulation, and whose Hb level is 8.0 g/dl or less, should be graded as having massive bleeding. Gastric ulcers with exposed blood vessels need endoscopic YAG laser hemostasis or ethanol injection therapy as quickly as possible, since 43% of the cases rebleed within 72 hours under conventional drug therapy, and such rebleeding can be prevented by the endoscopic hemostatic methods.
呕血、黑便、休克、模糊症状、贫血、血液检查及内镜检查结果作为近期出血的征象进行回顾。对上消化道出血患者病情的评估对于制定治疗方案很重要。因此，为了能够评估一种治疗胃肠道出血的方法，有关胃肠道出血治疗的报告必须包含患者病情严重程度及出血源的清晰记录。已提出大量出血的通用标准。具体而言，一名休克患者若在一小时内需要通过快速输血输入超过1000毫升血液或血浆扩容剂，或在最初24小时内需要超过2000毫升以稳定其循环，且血红蛋白水平为8.0克/分升或更低，则应被判定为大量出血。血管外露的胃溃疡需要尽快进行内镜YAG激光止血或乙醇注射治疗，因为在传统药物治疗下，43%的病例会在72小时内再次出血，而内镜止血方法可预防此类再出血。
