Analysis Of Endoscopic Diagnosis And Treatment On Acute Upper Gastrointestinal Bleeding

Objective: To analyze the cases of acute upper gastrointestinal bleeding(AUGIB)and the time of endoscopic examination in AUGIB and the efficiency and rebleeding rate of different endoscopic methods.Methods: Retrospective analysis 544 cases of acute upper gastrointestinal bleeding patients' clinical data of Guangxi Medical University Affiliated Hospital of Gastroenterology in January 2012-December 2016,by etiology is divided into non-variceal bleeding esophageal and gastric varices and hemorrhage.Analyze non-variceal bleeding and esophageal and gastric varices hemorrhage of General characteristics,emergency endoscopy in clinical application,different endoscopic treatment between the effective rate and rebleeding rate.Results: 1.Non-variceal bleeding: 377 cases were selected,308 males,69 females,the ratio of male to female is 4.5: 1.There were239(63.4%)patients underwent emergency endoscopy,of which206(86.2%)identified the cause;138(36.6%)patients received elective endoscopy,99(71.7%)identified the cause;9 patients did not detect the cause.The Top 5 causes were : 226(59.94%)cases of duodenal ulcer,98(25.99%)cases of stomach ulcers,12(3.18%)cases of acute hemorrhagic erosive gastritis,10(2.65%)cases of stomach ulcer,9(2.39%)cases of upper gastrointestinal bleeding of unknown causes.Fifty patients with Forrest?a-?b were treated with endoscopic treatment,22 cases were treated with drug aspiration,10 cases were drug injections,9 cases were treated with titanium,13 cases were treated by combined treatment method,6 cases of rebleeding,1 death.2.Esophageal variceal bleeding: 120 cases were selected,102males(85%),18 females(15%),the ratio of male and female is 5.7: 1.The main causes of hepatitis b and liver cirrhosis,94(78.3%),followed by alcoholic liver cirrhosis,22(18.3%).There was no statistically significant difference in Child-Pugh scores at admission and before discharge.According to the time of endoscopy,<24h group,24-48 h group and >48h group,the detection rate of the three groups was 46.2%,18.5% and 3%respectively,the difference was statistically significant.77 cases received endoscopic treatment,endoscopic manifestations of esophageal varices +gastric varices were the most,accounting for 61.0%.Followed by esophageal varices,33.8%,at least gastric veins,5.2%.49 cases(63.6%),42 cases were treated with esophagus(86%),15 cases(19.5%)were treated with tissue glue,14 cases were treated with stomach(93%),Treatment of 6 cases(7.8%),were used for esophageal;7 cases of esophageal varices + gastric varices were received a combination therapy.Endoscopic treatment in 5 cases(6.5%)occurred rebleeding,2 cases of conservative treatment after surgery without bleeding,1 case of endoscopic treatment without bleeding,1 case of surgery,1 case of automatic discharge.5 cases were treated with conservative treatment of internal medicine rebleeding,including 1 case of conservative treatment after surgery without bleeding,1 case of surgery;2 cases of death;1 case placed three cavity two cysts,the treatment is invalid,automatic discharge.Conclusions:1.The main etiology of acute non-variceal upper gastrointestinal bleeding is peptic ulcer,liver cirrhosis with HBV is a major cause in esophageal and gastric varices bleeding.2.The etiology detection rate of emergency endoscopy in non-variceal upper gastrointestinal bleeding and esophageal and gastric varices bleeding is higher than the elective endoscopy.3.Early endoscopy can improve the etiological detection rate of esophageal and gastric varices bleeding;EIS is still the main treatment in endoscopic treatment of esophageal and gastric varices bleeding,.