Katschinski B, Logan R, Davies J, Faulkner G, Pearson J, Langman M
Department of Therapeutics and Epidemiology, University Hospital, Nottingham, UK.
Dig Dis Sci. 1994 Apr;39(4):706-12. doi: 10.1007/BF02087411.
In this study we examined factors of possible prognostic value about outcome in a consecutive series of 2217 patients with hematemesis and melena. Death occurred in 189 (8.5%) patients, and 243 (11%) patients experienced rebleeding. Death was significantly associated with rebleeding, age over 60 years, and the finding of blood in the stomach at endoscopy. Rebleeding was significantly associated with melena, identification of a gastric or duodenal ulcer, endoscopic stigmata of hemorrhage such as blood, clot, and active bleeding, and the finding of shock at admission. However, female gender, previous history of ulceration, or indigestion of ulcerogenic drugs, especially nonsteroidal antiinflammatory drugs, were poor predictors of either death or rebleeding. We conclude that the identification of patients at a high risk could contribute to improved management of patients with gastrointestinal bleeding, including early therapeutic intervention.
在本研究中，我们对连续收治的2217例呕血和黑便患者的可能具有预后价值的因素进行了研究。189例（8.5%）患者死亡，243例（11%）患者再次出血。死亡与再次出血、年龄超过60岁以及内镜检查发现胃内有血液显著相关。再次出血与黑便、胃或十二指肠溃疡的诊断、出血性内镜特征（如血液、血凝块和活动性出血）以及入院时出现休克显著相关。然而，女性性别、既往溃疡病史或使用致溃疡药物（尤其是非甾体抗炎药）引起的消化不良，对死亡或再次出血的预测价值较差。我们得出结论，识别高危患者有助于改善胃肠道出血患者的管理，包括早期治疗干预。
