上消化道内镜对外科重症监护患者的分析:反流性食管炎的高发病率和发病率。

P W Plaisier, H R van Buuren, H A Bruining
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引用次数: 0

摘要

目的:探讨上消化道内镜在外科重症监护病房(ICU)中的作用。设计:回顾性分析。地点:荷兰大学医院。研究对象:男性87例,女性42例,平均年龄62.0岁(14-86岁)。干预措施:198例上消化道内镜检查。主要结局指标:上消化道内窥镜检查的发生率、适应症和异常。结果:52例(40%)和18例(14%)患者分别接受了82次和27次上消化道内镜检查,以评估上消化道出血和手术吻合。59例(46%)患者接受了89次内镜检查,放置鼻十二指肠饲管(n = 86,97%)、胆道支架(n = 2,2%)和胃造口导管(n = 1,1%)。出血原因有:食管炎(n = 13, 25%)、十二指肠溃疡(n = 13, 25%)、胃溃疡(n = 7, 13%)等(n = 14, 28%)。6例(11%)未发现出血部位。巧合的是,三分之一的患者患有食道炎。接受机械通气治疗和未接受机械通气治疗的患者出血发生率分别为43/1350(3.2%)和9/1470 (0.6%)(p < 0.0001)。结论:上消化道内窥镜检查是外科ICU常见的诊断和治疗方法。反流性食管炎是常见病,具有重要的临床意义。机械通气是上消化道出血的危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An analysis of upper GI endoscopy done for patients in surgical intensive care: high incidence of, and morbidity from reflux oesophagitis.

Objective: To investigate the role of upper gastrointestinal (GI) endoscopy in a surgical intensive care unit [ICU].

Design: Retrospective analysis.

Setting: University hospital, The Netherlands.

Subjects: 87 Male and 42 female patients, mean age 62.0 years (range 14-86).

Interventions: 198 Upper GI endoscopies.

Main outcome measures: Incidence of, indication for, and abnormalities noted at upper GI endoscopy.

Results: 52 (40%) and 18 (14%) patients underwent 82 and 27 upper GI endoscopies, respectively, for evaluation of upper GI haemorrhage and surgical anastomoses. 59 Patients (46%) underwent 89 endoscopies for placement of nasoduodenal feeding tubes (n = 86, 97%), biliary stents (n = 2, 2%) and gastrostomy cathether (n = 1, 1%). The causes of haemorrhage were: oesophagitis (n = 13, 25%), duodenal ulcer (n = 13, 25%), gastric ulcer (n = 7, 13%) and others (n = 14, 28%). In 6 cases (11%), no bleeding site was detected. As a coincidental finding, a third of all patients had oesophagitis. The incidence of haemorrhage in patients treated and not treated by mechanical ventilation was 43/1350 (3.2%) and 9/1470 (0.6%), respectively (p < 0.0001).

Conclusions: Upper GI endoscopy is a common diagnostic and therapeutic procedure in a surgical ICU. Reflux oesphagitis is often found and is clinically important. Mechanical ventilation is a risk factor for upper GI haemorrhage.

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