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首页> 外文期刊>Digestive Diseases and Sciences >Lower Endoscopic Diagnostic Yields Observed in Non-hematemesis Gastrointestinal Bleeding Patients
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Lower Endoscopic Diagnostic Yields Observed in Non-hematemesis Gastrointestinal Bleeding Patients

机译：在非呕血胃肠出血患者中观察到的内窥镜诊断产量

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BackgroundLocation of bleeding can present a diagnostic challenge in patients without hematemesis more so than those with hematemesis.AimTo describe endoscopic diagnostic yields in both hematemesis and non-hematemesis gastrointestinal bleeding patient populations.MethodsA retrospective analysis on a cohort of 343 consecutively identified gastrointestinal bleeding patients admitted to a tertiary care center emergency department with hematemesis and non-hematemesis over a 12-month period. Data obtained included presenting symptoms, diagnostic lesions, procedure types with diagnostic yields, and hours to diagnosis.ResultsThe hematemesis group (n=105) took on average 15.6h to reach a diagnosis versus 30.0h in the non-hematemesis group (n=231), (p=0.005). In the non-hematemesis group, the first procedure was diagnostic only 53% of the time versus 71% in the hematemesis group (p=0.02). 25% of patients in the non-hematemesis group required multiple procedures versus 10% in the hematemesis group (p=0.004). Diagnostic yield for a primary esophagogastroduodenoscopy was 71% for the hematemesis group versus 50% for the non-hematemesis group (p=0.01). Primary colonoscopies were diagnostic in 54% of patients and 12.5% as a secondary procedure in the non-hematemesis group. A primary video capsule endoscopy yielded a diagnosis in 79% of non-hematemesis patients (n=14) and had a 70% overall diagnostic rate (n=33).ConclusionNon-hematemesis gastrointestinal bleeding patients undergo multiple non-diagnostic tests and have longer times to diagnosis and then compared those with hematemesis. The high yield of video capsule endoscopy in the non-hematemesis group suggests a role for this device in this context and warrants further investigation.
机译：出血的背景分配可以在没有呕血的情况下提出患者的诊断挑战，所以除了血液化的患者。论呕吐物和非呕血的内镜诊断产量描述了呕吐和非呕血胃肠出血出血患者群体。关于343的群组的回顾性分析，连续鉴定胃肠道出血患者承认的胃肠道出血患者。在12个月内，呕吐中心急诊部和非呕血的急诊科。所获得的数据包括呈现症状，诊断病变，具有诊断产量的程序类型，以及数小时诊断。血液化组（n = 105）平均占15.6h，以达到非呕血组中的诊断与30.0h（n = 231 ），（p = 0.005）。在非呕血基团中，第一程序仅为呕血组仅为53％的时间而诊断（P = 0.02）。 25％的非呕血组患者需要多程序与呕血组中的10％（p = 0.004）。原发性食管造黄因的诊断产率为呕血基团对非呕吐基的50％（P = 0.01）为71％。主要结肠镜检查在54％的患者中诊断，12.5％作为非呕血组中的次要方法。主要视频胶囊内窥镜检查在79％的非呕吐患者（n = 14）中产生诊断（n = 14），总体诊断率为70％（n = 33）。Conlusionnon-呕吐胃肠道出血患者经过多个非诊断测试并具有更长的诊断的时间，然后将那些呕吐物进行比较。非呕血组中的视频胶囊内窥镜的高产率表明在这种情况下该装置的作用，并认证进一步调查。

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