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目的应用胃部彩色超声动态观察上消化道出血患者,探讨动态监测上消化道活动性出血的新方法。方法应用胃镜、胃部彩超动态检查入院的上消化道出血患者80例,比较彩超和胃镜诊断上消化道出血的差异,观察住院期间血红蛋白平均值和胃彩超诊断上消化道出血阳性人数的变化趋势。结果患者出血原因共6种,胃(或十二指肠)溃疡出血38例,食管胃底静脉曲张破裂出血26例,急性糜烂性胃炎伴出血13例,食管贲门黏膜撕裂1例,十二指肠血管畸形破裂出血1例,十二指肠间质瘤破溃出血1例。两种方法诊断上消化道出血差异无统计学意义(P>0.05)。两个检查项目住院第3天和第7天的结果与前一个时间点比较,差异有统计学意义(P<0.05)。结论在影像学方面,上消化道出血胃部彩超液性无回声内可见密集光点飘动或小团块状弱强回声,对应的胃镜结果为胃内咖啡色液体或暗红色液体且内掺杂血块,考虑为出血;胃部彩色超声可以作为一种诊断和动态监测上消化道出血的无创方法,且没有任何痛苦,操作简便,价格低廉,值得临床推广应用。
Objective To observe the dynamic monitoring of upper gastrointestinal bleeding in patients with upper gastrointestinal bleeding by color ultrasound. Methods 80 cases of upper gastrointestinal bleeding admitted to our hospital were examined by gastroscope and gastric color Doppler ultrasound. The difference between upper gastrointestinal bleeding diagnosed by color Doppler and endoscopy was compared. The changes of average hemoglobin during hospitalization and the number of upper gastrointestinal bleeding diagnosed by gastroscopy were observed . Results There were 6 causes of bleeding in patients, 38 cases of gastric ulcer (bleeding), 26 cases of esophageal variceal bleeding, 13 cases of acute erosive gastritis with hemorrhage, 1 case of esophageal mucosal tear, One case of rupture of finger vascular deformity, one case of rupture of duodenal stromal tumor. There was no significant difference between the two methods in the diagnosis of upper gastrointestinal bleeding (P> 0.05). The results of hospital stay on the third and seventh days of the two examinations were statistically different from the previous time point (P <0.05). Conclusions In imaging, upper gastrointestinal bleeding gastric ultrasonographic anechoic dense dense spot or flocculent mass weak echo, the corresponding endoscopy results for the stomach brown liquid or dark red liquid and mixed with blood clots , Considered as bleeding; stomach color ultrasound can be used as a diagnosis and dynamic monitoring of upper gastrointestinal bleeding noninvasive method, and without any pain, easy to operate, low cost, worthy of clinical promotion and application.