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抗血小板药物相关性非静脉曲张上消化道出血患者再次出血的随访研究
作者:贾逸文  唐阳  冯广铭  彭琼 
单位:合肥市第一人民医院 消化内科, 安徽 合肥 230001
关键词:抗血小板药物 非静脉曲张上消化道出血 随访研究 危险因素 
分类号:R573.2
出版年·卷·期(页码):2021·49·第三期(289-293)
摘要:

目的:探讨抗血小板药物引起非静脉曲张上消化道出血的患者随访期间再出血的危险因素。方法:回顾性收集我院2017年1月至2019年12月抗血小板药物相关性非静脉曲张上消化道出血患者临床资料,根据随访时是否再次发生上消化道出血分为观察组(143例)和对照组(152例)。采用Blatchford评分与AIMS65评分评估患者出血严重程度,通过改良Lanza评分评估胃肠黏膜损伤严重程度,分别比较两组患者临床特征及内镜表现。结果:两组患者年龄、性别、首次入院时血红蛋白量、入院时是否存在失血性休克、合并基础病,Blatchford评分以及AIMS65评分等比较差异均具有统计学意义(P<0.05)。随访期间,上消化道出血平均缓解时间(23.89±1.16)个月,随访3个月累计缓解率0.96±0.04,第15个月累计缓解率0.89±0.07。Cox回归法单因素分析发现,首次入院时血红蛋白量、是否存在休克状态、是否合并基础病以及改良Lanza评分均具有统计学意义(P<0.05)。结论:首次入院时低血红蛋白量、存在休克状态、合并基础病以及胃肠黏膜损伤严重是导致抗血小板药物相关性非静脉曲张上消化道出血患者出院后再次出血的危险因素。

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