Value Of Emergency Gastroscopy In Diagnosis And Treatment Of Upper Gastrointestinal Diseases

Objective: To make a retrospective analysis of the diagnosis and treatment of upper gastrointestinal diseases by emergency gastroscopy,investigate the pathogeny and its relationship with gender,age and onset season,understand the similarities and differences of the incidence of the region and other places,and analyze the endoscopic therapy and its curative effect to further guide the clinical diagnosis and treatment.Methods: The data were inquired from 627 patients who were admitted to the First Affiliated Hospital of Fujian Medical University and registered in the computer system from 2012 to 2016 for emergency gastroscopy to make the comparative analysis on the causes of emergency gastroscopy and their relationships with gender,age and season,and analyze the difference of endoscopic therapy and its curative effect.Results: 1.1.There were 560 cases of UGIH and 67 cases of foreign bodies in upper gastrointestinal tract among 627 cases of emergency gastroscopy patients.There was no statistically significance between the two groups in the examination year and season(P>0.05),while there was statistically significance in gender and age distribution(P<0.05).UGIH group mainly consisted of male,and the incidence of foreign bodies in upper gastrointestinal tract in youth group was significantly higher.2.The pathogeny of UGIH was common in patients with successive duodenal ulcer(DU),esophageal varices(EGV),gastric ulcer(GU),and upper gastrointestinal malignant tumor.Peptic ulcer(PU)was the most common,accounting for 47.9%,and the incidence of PU increased year by year.For four most common pathogeny study of PU,EGV,upper gastrointestinal malignant tumor and acute gastric mucosal lesions(AGML),there was no statistically significance between the four groups in differences of gender and examination season(P>0.05).For the age distribution,PU was the most common in the youth group,and upper gastrointestinal malignant tumor in elderly group was significantly higher than that in youth group(P<0.05).PU endoscopic hemostatic therapy was mainly drug spraying and injection as well as combination therapy,and the immediate hemostasis rate by drug spraying and injection was highest(98.7%).EGV endoscopic therapy was mainly the loop ligature and tissue adhesive.The immediate hemostasis rate of emergency endoscopy was 94.4%,with the highest rate of PU(97.4%).The immediate hemostasis rate of upper gastrointestinal malignant tumor was the lowest(75.6%).Endoscopic combination therapy was the most common therapy among all the therapies(44.5%).3.Foreign bodies in upper gastrointestinal tract were mainly from food,accounting for 89.6%,and the fish bone stuck in the esophagus due to wrong ingestion was the most common.The removal rate of foreign bodies in upper gastrointestinal tract was 87.5%.Complications of foreign body injury included mucosal injury(32.8%),bleeding(22.4%)and ulcer(14.9%),without cases of perforation and death.Conclusion: UGIH and foreign bodies in upper gastrointestinal tract are the most common causes of emergency gastroscopy.The pathogeny of UGIH is related to gender and age.PU showed an increasing trend with years,while the others have little changes.PU,EGV,upper gastrointestinal malignant tumor and AGML are the most common for the pathogeny of UGIH.Emergency endoscopic combination hemostatic therapy is a relatively good treatment for AUGIH.There is no significant difference for foreign bodies in upper gastrointestinal tract in gender,age and examination season,and the fish bone stuck in the esophagus due to wrong ingestion is the most common.The removal of foreign bodies in the upper gastrointestinal tract is related to the character of the foreign body and the location as well as the way of its retention.