浙江医学2025，Vol.47Issue(20)：2187-2191,5.DOI:10.12056/j.issn.1006-2785.2025.47.20.2024-2779
急性食管胃静脉曲张破裂出血不同场地急诊内镜止血疗效比较
Comparison of the efficacy of emergency endoscopic hemostasis for acute esophagogastric variceal bleeding at different site
摘要
Abstract
Objective To compare the efficacy and outcomes of emergency endoscopic hemostasis performed bedside procedure versus in the operating room for acute esophagogastric variceal bleeding(EGVB).Methods A total of 149 patients with cirrhosis and acute EGVB who underwent emergency endoscopic hemostasis at three tertiary hospitals in Zhejiang Province between November 2021 and December 2023 were retrospectively enrolled.Patients were divided into Group A(n=68)undertook bedside endoscopy with endotracheal intubation performed by emergency physicians and Group B(n=81)undertook endoscopy in the operating room with endotracheal intubation performed by anesthesiologists.Preoperative risk,anesthesia time,operation time,hemostasis success rate,extubation time,aspiration pneumonia,hospital stay,costs,mortality,and rebleeding rates were compared between two groups.Results There were statistically significant differences in the intraoperative bleeding time,postoperative hospital stay,cost,and incidence of aspiration pneumonia between the two groups(all P＜0.05).No significant differences were found in postoperative early rebleeding,delayed rebleeding,liver function,renal function,D-dimer,prothrombin activity at 4 weeks post-operation and mortality at 6-week after surgey(all P＞0.05).No serious embolic events occurred in either group after the operation.Conclusion Emergency endoscopic hemostasis for acute GEVB achieves comparable efficacy whether performed at the bedside or in the operating room.However,for patients with massive bleeding or shock,bedside endoscopy offers significant advantages,including a reduced risk of aspiration pneumonia,shorter hospital stays,and lower medical costs.关键词
食管胃静脉曲张破裂出血/急诊内镜/床旁/手术室/急诊止血Key words
Esophagogastric variceal bleeding/Emergency endoscopy/Bedside procedure/Operating room/Emergency hemostasis引用本文复制引用
韦炜,洪依萍,陶茂根,陈翀,蔡建庭..急性食管胃静脉曲张破裂出血不同场地急诊内镜止血疗效比较[J].浙江医学,2025,47(20):2187-2191,5.基金项目
金华市科学技术研究计划项目(2021-4-022) （2021-4-022）
