科技论文设计写作结课作业.docx

科技论文设计写作结课作业.docx

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科技论文设计写作结课作业

Non-varicealgastrointestinalbleeding,endoscopictherapyclinicalanalysis

Abstract:

Objective:

Tostudytheobservedendoscopictreatmentofnon-varicealgastrointestinalbleedingclinicaleffect. Methods:

OurhospitalinMarch2010toSeptember2011weretreated100casesofnon-varicealgastrointestinalbleedingpatients,allpatientswerediagnosedbyendoscopyareendoscopictreatment,comparedwithbeforetreatment.Results:

100patientsinthetreatmentof94patientsimmediatelyafterbleeding,6patientsunsuccessfulretrobulbarbleedingulcerbleeding,curerateof94%,including4patientsinthetreatmentofbleedingagainwithintwodaysaftertheimplementationofthesecondtreatment,3patientswithin48hoursofsuccessfulhemostasisandnobleeding,onecaseofbleedingintothedepartmentreceivesaninvalidcontinuetreatment,andtreatmentthanbefore,bleedingsignificantlyreducedthenumberofcases,comparedtoP<0.05wasconsideredstatisticallysignificant,statisticallysignificant.Conclusions:

non-varicealgastrointestinalbleedingimplementationofendoscopictherapyisahighsafetyandefficacymeans,butitshouldbenotedthatthedoctoraccordingtothepatient'sspecificsituationtochoosethemethodofendoscopichemostasis.

Keywords:

non-variceal,gastrointestinalbleeding,endoscopictherapy

Therearemanycausesofgastrointestinalbleeding,withthedevelopmentofmedicaltechnology,endoscopictherapyhasbeenwidelyusedclinically,theauthorforfurtherstudyofendoscopictreatmentofnon-varicealgastrointestinalbleedingclinicalresults,selectedinourhospital100casesofnon-varicealgastrointestinalbleeding,endoscopictherapyareusedtoobtainsatisfactoryresults,aresummarizedasfollows[1]. 

1MaterialsandMethods1.1ClinicaldatainourhospitalinMarch2010toSeptember2011weretreated100casesofnon-varicealgastrointestinalbleedingpatients,allpatientswerediagnosedbyendoscopy.61patientsweremale,39femalepatientspatients,aged17to69years,meanage42+-7.5yearsold,ofwhichthreecasesofanastomoticulcerand16duodenalulcer,26casesofgastriculcer,15casesofcomplexulcers,ninecasesofacutegastricmucosallesionwithhemorrhage,17casesofesophagus,stomachbleedingafterpolypectomy,theother14cases.mainclinicalsymptoms:

blackstools,vomiting,oftenaccompaniedwithhypovolemiacausedbyacuteperipheralcirculatoryfailure[2]. 

1.2Methods1.2.1hemostaticpreparationforaseriousconditionandthefactthattheamountofbleedingandhemodynamicchangescausedpatientstopromptlygivebloodvolumesupplementtomaintainbloodpressure,atthesametimecare,whenpatientsareinstableconditionafterendoscopyfortheexcessivebleedingcausedbyanemiapatientsshouldbegivenpromptcorrectivetreatmentuntilcheckthepatient'shemoglobinisnotlessthan70g/L,andthenre-examination,inordertoavoiddamagetothedigestivetractendoscopytubeinspection,sointuitivegastroscopyunderlocalicesalineflush,suctionandchangesinpositionandothermethodstoavoidtheimpactoftheobservedbleedingmore. 

1.2.2endoscopictreatmentofpatientsbeforeendoscopywereperformedtodeterminethesiteofbleedingwouldneedleinsertedthroughtheendoscopebiopsychannel,thendruginjection,bleedingaroundthesiteintheinjectionofthedrugdirectlyinjectedinthebloodvesselsWhenyoufeelresistancewhentheinjectionisstoppedfornon-injectiontreatmentofvaricoseveinsisnotidealfor

Patientscanbehemoclipping.

1.3StatisticalanalysisAlldatainthisstudyusingSPSS18.0statisticalsoftware,measurementdatausingttest,comparedbetweengroupsusingtheX2test,P<0.05wasconsideredstatisticallysignificant,withstatisticalsignificance.

2resultsinthetreatmentof100patients,94patientsimmediatelyafterbleeding,6patientsretrobulbarbleedingulcerbleedingunsuccessful,thecureratewas94%,ofwhichthereareFourpatientsinthetreatmentofbleedingagainwithintwodaysaftertheimplementationofthesecondtreatment,3patientswithin48hoursofsuccessfulhemostasisandnobleeding,onecaseofbleedingintothedepartmentreceivesaninvalidcontinuetreatment,comparedwithbeforetreatment,thenumberofcasesofbleedingsignificantlyreduced,comparedtoP<0.05wasconsideredstatisticallysignificant,statisticallysignificant,

AsshownintableI.

3referstoadiscussionofthedigestivetractbetweentheesophagustotheanuspipeline,includingthroughtheesophagus,stomach,duodenum,jejunum,ileum,cecum,colonandrectum,whilegastrointestinalbleedingisclinicallymorecommondiseases,lighttotakeeffectivetreatmentcanbecured,andmightseriouslydamagethepatient'sbody.gastrointestinalbleedingmainclinicalsymptomsaremanifestedasbloodinthestool,blackstools,vomiting[3].patientsvomitingbrightredcolormaybealsopossiblethatbrown,brightredbloodinthestoolcolorcanalsoberendered,darkandtarryblack.complexcausesofgastrointestinalbleeding,clinicalexaminationcausesofmorbidityinthemomentconsiderthepatient'smedicalhistory,clinicalsignsandthemainsymptoms,butthelocationandcauseofbleedingisrequiredbymechanicalinstrumenttodetermineatthetimeofdiagnosistopayspecialattentiontouppergastrointestinalbleedingandsomeexclusionoflowergastrointestinalbleedingdisorders[4].clinicalstudyfoundthatnon-varicealgastrointestinalbleedingisthemostcommonfactorsaretumor（endoscopictreatment,mucosaltear,mucosallesions,inflammationandulcers,themostimportantfactoristhepepticulcerbleeding.gastrointestinalbleedingwithacuteillness,ischaracterizedbyrapidchangecanbeseriousthreatstothelivesofpatients,soitisimportanttoclinicalrescue[5]Inthesalvagetherapy,anti-shock,quicklyaddvolumeistotreatbasis.clinicalbleedingaccordingtothepatient'sbloodvolumetodeterminetheamountofthesupplement,whiletheclinicaltreatmentofgastrointestinalbleedingextinctiontherearemanyways（conservativetreatment,interventionalradiologytreatment,surgery,endoscopictherapy,comprehensivetreatment,andwiththedevelopmentofmedicaltechnology,endoscopictherapyinclinicalplayinganincreasinglyimportantrole,inthisstudytheauthorselected100casesnon-varicealgastrointestinalbleedingpatientsweretreatedwithendoscopictherapyresultsshowthat100patientsinthetreatmentof94patientsimmediatelyafterbleeding,6patientswithbleedingulcerbleedingaftertheballisunsuccessful,thecureratewas94%.includingfourpatientsinthetreatmentofbleedingagainwithintwodaysaftertheimplementationofthesecondtreatment,3patientswithin48hoursofsuccessfulhemostasisandnobleeding,onecaseofbleedingintothedepartmentreceivesaninvalidcontinuetreatment,comparedwithbeforetreatment,bleedingsignificantlyreducedthenumberofcases,comparedtoP<0.05wasconsideredstatisticallysignificant,statisticallysignificant,whichshowsthattheimplementationofnon-varicealgastrointestinalbleedingendoscopictherapyisahighsafetyandefficacyofthemeans,butneedsNotethatthedoctoraccordingtothepatient'sspecificsituationtochoosethemethodofendoscopichemostasis. 

References:

[1]Zhang,XuMeidong,ChenWeiFeng. Endoscopictreatmentofacutenon-varicealuppergastrointestinalbleedingclinicalvalue[J].ChineseC

[2]XumeiDong,ChenWeiFeng,MaLili. Endoscopicinjectionsclerotherapymetalclipsandtreatmentofpepticulcerbleeding[J].ChineseClinicalMedicine,2008,15（06）:

814-815. 

[3]JournalofInternalMedicineEditorialBoard. Acutenon-varicealgastrointestinalbleedingtreatmentguidelinesquotient[J].JournalofInternalMedicine,2009,08（10）:

891. 

[4]QiuZan,ZhaoKui,WangBangmao. Endoscopichemoclippingclinicalvalueofhigh-riskpepticulcerbleeding[J].ChinaJournalofEndoscopy,2009.15（02）:

146. 

[5]LOCC,HSUPl,LOGH,eta1.Comparisonofhemostatieefficacy 

ForEpinephrineInjectionAloneAndInjectionCombinedWithHemoclip

thempyintreatinghishriskbleedingulcers[J]. GastronintestEndose,2006,63（06）:

774.

非静脉曲性消化道出血的镜下治疗方法的临床分析

摘　要：

目的：

研究观察镜下治疗非静脉曲性消化道出血的临床效果。

方法：

选取我院于2010年3月至2011年9月收治的100例非静脉曲性消化道出血患者，所有患者均经胃镜检查确诊，均在镜下进行治疗，并与治疗前进行对比。

结果：

100例患者中在治疗后有94例患者即时止血，6例患者球后溃疡出血止血不成功，治愈率为94%。

其中有4例患者在治疗后两天再次出血，实施第二次治疗，3例患者止血成功且48小时无出血情况，1例止血无效转入科室接受继续治疗，与治疗前相比，出血例数明显减少，对比P＜0.05为差异有显著性，有统计学意义。

结论：

非静脉曲性消化道出血实施镜下治疗是一种安全性与有效性较高的手段，但是需要注意的是医生要根据患者的具体情况来选择镜下止血的方法。

关键词：

非静脉曲性；消化道出血；镜下治疗 

　　消化道出血的原因有很多，随着医学技术的发展，镜治疗已被广泛应用于临床，笔者为进一步研究镜下治疗非静脉曲性消化道出血的临床效果，选取了我院收治的100例非静脉曲性消化道出血患者，均采用镜下治疗，取得满意效果，现作如下总结。

　　1资料与方法

　　1.1临床资料

　　选取我院于2010年3月至2011年9月收治的100例非静脉曲性消化道出血患者，所有患者均经胃镜检查确诊。

其中男性患者61例，女性患者39例，年龄17～69岁，平均年龄42±7.5岁。

其中3例吻合口溃疡，16例十二指肠球部溃疡，26例胃窦溃疡，15例复合溃疡，9例急性胃黏膜病变伴出血，17例食管、胃息肉切除后出血，其他14例。

主要临床症状：

黑便、呕吐，多伴有血容量减少而引起的急性周围循环衰竭。

　　1.2方法

　　1.2.1止血前准备

　　对于病情严重及由于出血量多而引发血流动力学变化的患者要及时给予血容量补充，维持血压，同时进行监护，当患者病情稳定后即胃镜检查。

对于由于失血过多而引起贫血的患者要及时给予纠正治疗，直到检查患者的血红蛋白不低于70g／L，然后再行镜检，为了避免胃镜插管检查损伤消化道，所以在胃镜检查时直观下局部冰生理盐水冲洗、抽吸及改变体位等方法来避免出血较多对观察的影响[1]。

　　1.2.2镜治疗

　　患者在治疗前均进行胃镜检查，从而确定出血部位。

将注射针通过镜活检通道插入，再进行药物注射，可在出血部位周围注射液可直接将药物注射在血管。

当注射时感觉到有阻力则停止。

对于非曲静脉性注射治疗后效果不理想的患者可进行止血夹治疗[2]。

　　1.3统计学分析

　　本次研究所有数据均采用SPSS18.0统计学软件处理，计量资料采用t检验，组间对比采用X2检验，P＜0.05为差异有显著性，有统计学意义。

2结果

　　100例患者中在治疗后有94例患者即时止血，6例患者球后溃疡出血止血不成功，治愈率为94%。

其中有4例患者在治疗后两天再次出血，实施第二次治疗，3例患者止血成功且48小时无出血情况，1例止血无效转入科室接受继续治疗；与治疗前相比，出血例数明显减少，对比P＜0.05为差异有显著性，有统计学意义，如表一所示：

　　3讨论

　　消化道指的是食管到肛门之间的管道，其中经过食管、胃、十二指肠、空肠、回肠、盲肠、结肠及直肠。

而消化道出血则是临床上较为常见的疾病，轻者采取有效治疗即可痊愈，重者可严重损伤患者身体。

消化道出血的临床主要症状多表现为便血，黑便、呕吐等[3]。

患者呕吐的血色有可能是鲜红的也有可能的是咖啡色，便血颜色也可呈现鲜红、暗红及柏油样黑色。

消化道出血的原因复杂，临床在检查发病原因时刻考虑患者的病史、体征及临床主要症状，但是出血的部位及原因则需要通过机械仪器来确定。

在诊断时要特别注意上消化道出血和下消化道