Study On The Etiology And Endoscopic Time Choice Of Acute Non Variceal Upper Gastrointestinal Bleeding

Objective: 1.Objective to investigate the characteristics of acute non variceal upper gastrointestinal bleeding etiology in Shaanxi area,and to strengthen the understanding of ANVUGIB and guide clinicians to make accurate judgement and reasonable treatment for ANVUGIB.2.Objective to investigate the optimal time of endoscopy and guide the clinician’s choice of endoscopic diagnosis and treatment time.Method: Retrospective randomly selected from Shaanxi People’s Hospital in January2014-2016 year in December with different degrees of hematemesis and melena or as symptoms of ANVUGIB cases were 420 cases,according to the inclusion and exclusion criteria included a total of 351 cases,the patients underwent endoscopic examination confirmed the diagnosis of ANVUGIB,and all patients underwent endoscopic hemostasis.The selected 351 cases diagnosed as ANVUGIB cases were divided into different groups according to gender,age,season and year,analysis of the causes and characteristics of the disease.The time of endoscopy were divided into 3 groups,namely within 24 h Endoscopy Group,24-48 h group and 48 h after endoscopy Endoscopy Group,The etiology,diagnosis rate,mortality rate,hospitalization time and hospitalization expenses were compared.Analyze the factors that affect hospitalization expenses.Result: 1.The results of the etiological analysis showed that peptic ulcer accounts for16.24%,acute gastric mucosal lesion accounts for 13.68%,digestive tract tumor accounts for 10.83%,and esophageal and cardiac mucosa tear syndrome account for 6.55%.2.The comparison of etiological components in different sexes showed that the incidence of peptic ulcer in male was 85.19%,and the incidence rate of female was 14.81%.The difference was statistically significant by P<0.05.3.Comparison of various ANVUGIB causes in different age groups causes,the results showed that DU occurs in young and middle-aged people,higher than that of the elderly(P<0.05),GU was higher in the elderly than that in middle-aged and young people(P<0.05),acute gastric mucosal lesions and tumors are more common in the elderly,which was significantly higher than that of middle-aged and young people(P<0.05).4.The different incentives of ANVUGIB were compared in different age groups,the results showed that the incidence of NSAIDs related bleeding was greater in the elderly than in the middle-aged and the young(P<0.05),and the middle-aged and the young were more likely to be bleeding due to alcohol consumption,fatigue and emotional agitation(P<0.05).5.The drug of acute gastric mucosal lesions and NSAIDs changes in the past 3 years.After analyzing the results shown: the incidence of acute gastric mucosal lesion and the pathogenesis of NSAIDs in 2015 was higher than that of drug associated bleeding rates in 2014.In 2016,the incidence rate exceeded the incidence rate in 2015,P<0.05,the difference was statistically significant.6.Comparing the different etiology of ANVUGIB in different seasons,the results showed that there was no significant difference in each etiology in different seasons,P>0.05,the difference was not statistically significant.7.The cause of disease,the rate of diagnosis,the length of stay and the cost of hospitalization were related to the time of endoscopy.The results showed that 24 h within the Endoscopy Group hospitalization compared with 24-48 h Endoscopy Group and 48 h after endoscopy group(P<0.05),short hospitalization time(P<0.05),the etiological diagnosis of high rate(P<0.05),but no significant difference in mortality between the 3 groups(P>0.05).8.The results of multivariate linear regression analysis showed that there was linear relationship between the time of endoscopy,the length of stay,the levy and expenses,and the factors affecting the cost.Conclusion:1.In ANVUGIB etiology,the incidence of acute gastric mucosal lesions is higher than that of digestive tract tumors,which may be related to the use of NSAIDs drugs.2.After the patient is admitted to hospital as soon as possible endoscopy can improve the diagnosis rate,shorten hospitalization time,reduce hospitalization costs.