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- Rebleeding Rate of Various Stigmata of Recent Hemorrhage in Peptic Ulcer Bleeding with Different Severity
- 消化性潰瘍出血的內視鏡治療
- C丨 Urea Breath Test Combined with Symptomatology is Helpful in Deciding Which Dyspeptic Patients Need Endoscopy to Rule in Peptic Ulcer
- 上消化道出血之內視鏡檢查
- 非靜脈曲張性上消化道出血的內視鏡診斷與治療
- 內視鏡注射法治療消化性潰瘍出血
- 兒童消化性潰瘍之臨床與內視鏡觀察報告
- Endoscopic Local Hemostasis with Hypertonic Saline-Epinephrine Solution Injection for Upper Gastrointestinal Bleeding
- 內視鏡局部注射止血法對上消化道出血之治療
- Upper Gastrointestinal Endoscopy in Children with Upper Gastrointestinal Bleeding
頁籤選單縮合
題名 | Rebleeding Rate of Various Stigmata of Recent Hemorrhage in Peptic Ulcer Bleeding with Different Severity=消化性潰瘍出血量與其各式出血徵候之再出血率 |
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作者 | 陳志州; 張簡吉幸; 李全謨; 胡琮輝; 蕭志銘; 陳建霖; 許家彰; 呂朝英; 林正琴; |
期刊 | 長庚醫學 |
出版日期 | 19950900 |
卷期 | 18:3 1995.09[民84.09] |
頁次 | 頁209-216 |
分類號 | 415.526 |
語文 | eng |
關鍵詞 | 潰瘍出血徵候; 消化性潰瘍; 上消化道出血; 內視鏡; Stigmata of recent hemorrhage; Peptic ulcer; Upper gastrointestinal bleeding; Panendoscopy; |
中文摘要 | 消化性潰瘍出血其基底之各式出血徵候常用來預測潰瘍再出血之機率,而於潰瘍基底之突出血管(即護衛性血栓,sentinel clot)之再出血率各篇報告之結果不同。有一假說認為各式出血徵候顏色之不同乃因其血塊機化時期不同之故,血塊機化程度不同,其牢固程度亦不同,故其再出血率應不相同。本研究即討各式出血徵候之出血機率,且觀察血量與再出血率之關係。於623例消化性潰瘍出血之病人中(含474男性,149女性。平均年齡59歲),有232例胃潰瘍,369指腸潰瘍,22例邊緣性潰瘍,有出血徵候者62%(387例),全部病例之再出血率為19.6%。胃潰瘍之再出率較十二指腸潰瘍為高(424.2%%比16.3%,P<0.05),尤其以血或有護衛性血栓者有明顯之差別。在活動性出血、大血塊、護衛性血栓、與其它種類出血徵候之再出血率各為35%、24.8%、17%、與11.3%。在各種出血徵候中色徵候較黑色有較高之再出血率,惟統計上未達有意義之差別。有五例血色之護衛性血栓病例皆無再出血。比較大量出血與小量出血間各種不同出血徵候之再出血率,大量出血之病人有顯著較高之再出血率,(50.5%比6.6%,P<0.001)。結論:不同顏色、種類之出血徵候代表出血血管護衛性血栓癒合之不同時期,白色之護衛性血栓可能不會再出血;而相同之出血徵候於大量出血者較易再出升,因此,預測潰瘍再出血時合併臨床出血量與內視鏡之發現可有較高之正確性。 |
英文摘要 | The stigamata of recent hemorrhage (SRH) have been used as a factor for predicting peptic ulcer rebleeding. In previous studies, the rebleeding rate of the visible vessel varied. A hypothesis had been proposed stating that the evolution of the color of the stigmata depends on the point in the healing process of the blood clot on the bleeding ulcer. This retrospective study evaluates the rebleeding rates associated with various colors of stigmata of recent hemorrhage. Of a total of 623 cases of peptic ulcer bleeding (474 male and 149 female, with a mean age of 59 years old), there were 232 gastric ulcers, 369 duodenal ulcers, and 22 stomal ulcers. Stigmata of recent hemorrhage were found in 387 cases (62%). The overall rebleeding rate for patients with stigmata of recent hemorrhage was 19.6%. The rebleeding rate for those with gastric ulcers was higher than for those with duodenal ulcers (24.2% versus 16.3%, p<0.05), especially for oozing and sentinel clots. the rebleeding rates for active bleeding, blood clots, sentinel clots, and others were 35%, 24.8%, 17%, and 11.3% respectively . The red clot of stigmata of recent hemorrhage had a slightly higher rebleeding rate than the black clot, but the difference was not statistically important. Furthermore, the 5 duodenal ulcers with white sentinel clots experienced no rebleeding. When comparing the rebleeding rates between groups with massive and minor bleeding, a significantly higher rebleeding rate was found in the massive bleeding group (50.5% versus 6.6%, p<0.001). It can thus be seen that the different types of stigmata of recent hemorrhage represent different stages in the healing process of a bleeding ulcer. A white sentinel clot had a chance of not rebleeding. Thus, in the future a combination of clinical and endoscopic findings will likely yield more accurate predictions of rebleeding rates. |
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