The Effect Of Endoscopic Diagnosis And Treatment Of Elderly Patients With Acute Non-variceal Upper Gastrointestinal Bleeding At Different Times

Objective To investigate the clinical application value of endoscopic diagnosis and treatment of elderly patients with acute non-variceal upper gastrointestinal bleeding at different timings.Methods The clinical data of patients with acute non-variceal upper gastrointestinal bleeding diagnosed in the elderly at the People’s Hospital of Ningxia Hui Autonomous Region from May 2014 to September 2019 were retrospectively collected.According to the different time of endoscopy,there were 102 cases in the very early endoscope group(endoscopic examination at admission ≤ 12h)and 112 cases in the early endoscopic group(endoscopic examination at admission 12 to 24h).General clinical data of acute non-variceal upper gastrointestinal bleeding,comparing the etiology,main comprehensive outcomes(including rebleeding,surgical hemostasis,transfer to ICU,30-day readmission,in-hospital death)and secondary comprehensive outcomes(including transfusion The number of red blood cell injections,the time of endoscopy,and the length of hospital stay)and their analysis were the main predictors of overall outcome.Results Very early endoscopic examination in elderly patients with acute non-variceal upper gastrointestinal hemorrhage was higher than the early endoscopic examination in the total number of cases detected,and the difference between the two groups was statistically significant(P<0.05);The most common cause of acute non-variceal upper gastrointestinal bleeding in the elderly is peptic ulcer bleeding,accounting for 73.83%,Other causes in order are 9.35% of gastric cancer,4.67%of acute gastric mucosal lesions,Mallory-Weiss syndrome and other rare causes of bleeding were 2.80%;Compared with the early endoscopic examination group,the elderly patients in the very early endoscopic examination group after surgery had higher treatment effects in terms of re-bleeding,transfer to the ICU,30-day readmission,and death in the hospital.However,the very early endoscopic examination group was shorter in terms of hospitalization time and endoscopic examination time,and the difference between the two was statistically significant(P<0.05).In addition,the difference between the two in terms of surgical hemostasis is not statistically significant(P>0.05);GBS is a predictor of the main comprehensive outcomes of endoscopic diagnosis and treatment of elderly patients with acute non-variceal upper gastrointestinal bleeding,GBS and endoscopic examination time are the common predictors of the main comprehensive outcomes of early endoscopic diagnosis and treatment of elderly patients with acute non-variceal upper gastrointestinal bleeding.Conclusion Very early endoscopic examination has not improved the main clinical prognosis of elderly patients with acute non-variceal upper gastrointestinal bleeding.The practical benefits of very early endoscopic examination need to be further clarified in the future.GBS is a predictor of the main comprehensive outcomes of very early endoscopic diagnosis and treatment of the disease.The main predictive factors for the comprehensive outcome of early endoscopy are GBS and endoscopic examination time.