{"title":"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。","authors":"P W Plaisier, H R van Buuren, H A Bruining","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the role of upper gastrointestinal (GI) endoscopy in a surgical intensive care unit [ICU].</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>University hospital, The Netherlands.</p><p><strong>Subjects: </strong>87 Male and 42 female patients, mean age 62.0 years (range 14-86).</p><p><strong>Interventions: </strong>198 Upper GI endoscopies.</p><p><strong>Main outcome measures: </strong>Incidence of, indication for, and abnormalities noted at upper GI endoscopy.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An analysis of upper GI endoscopy done for patients in surgical intensive care: high incidence of, and morbidity from reflux oesophagitis.\",\"authors\":\"P W Plaisier, H R van Buuren, H A Bruining\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the role of upper gastrointestinal (GI) endoscopy in a surgical intensive care unit [ICU].</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>University hospital, The Netherlands.</p><p><strong>Subjects: </strong>87 Male and 42 female patients, mean age 62.0 years (range 14-86).</p><p><strong>Interventions: </strong>198 Upper GI endoscopies.</p><p><strong>Main outcome measures: </strong>Incidence of, indication for, and abnormalities noted at upper GI endoscopy.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":22411,\"journal\":{\"name\":\"The European journal of surgery = Acta chirurgica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1997-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The European journal of surgery = Acta chirurgica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The European journal of surgery = Acta chirurgica","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.