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| 1 | 危险性急性上消化道出血141例临床诊治分析显示文摘目的回顾性分析危险性急性上消化道出血的急诊治疗方法,以提高治疗水平,并比较AIMS65评分、Glasgow-Blachford(GBS)评分、Pre—Rockall评分在预后评估中的准确性,评价他们的临床价值。方法收集2013年11月1日至2017年5月31日北京积水潭医院急诊科收治的危险性急性上消化道出血患者141例,回顾分析治疗方法及结果。所有患者均在急诊抢救室接受药物治疗,并联合多个科室对部分患者行内镜检查、介入治疗或手术治疗。分别计算三种评分的分值,以院内死亡或30d内死亡、再出血为终点指标,绘制ROC曲线,比较曲线下面积(AUC)以评价3种方法的优劣。结果内镜检查65.25%(92/141),出血病因首位是消化性溃疡,占64.12%。8例内镜下止血夹治疗,4例硬化治疗,4例三腔二囊管压迫止血,9例介入栓塞(therapeutic embolization approach,TEA)治疗,3例经颈静脉肝内门体支架分流术(TIPS),2例手术治疗。再出血率14.18%,病死率11.35%。AIMS65、Pre—Rockall在预测病死率方面优于GBS,而预测再出血率差异无统计学意义。结论药物联合内镜、介入、外科手术等可有效救治危险l生上消化道出血,AIMS65、Pre—Rockall评分法使用简便,均能准确预测患者病死率,适用于急诊对上消化道出血的风险评估。 | 涂家红 张明清 赵斌 | 2018 | 中华急诊医学杂志2018，27，5： | 60 |
| 2 | 急性非静脉曲张上消化道出血的内镜治疗显示文摘内镜作为临床上急性非静脉曲张上消化道出血(acute non-variceal upper gastrointestinal bleeding,ANVU-GIB)治疗的首选,在不同条件下选择的方法存在差异,其中内镜喷洒主要用于弥漫性渗血、静脉出血等疾病,常作为其他内镜治疗的辅助治疗方法;内镜注射常用于大面积渗血、活动性出血难以明确的病变;内镜凝固治疗常用于活动性渗血、注射治疗难以止血的病变;钛夹及套扎器械止血广泛适用于各种出血病灶;联合治疗可有效提高止血率及再出血率。本文旨在为临床医师及时准确选择内镜止血方法提供依据。 | 苟菊花 张秉强 | 2016 | 胃肠病学和肝病学杂志2016，25，7： | 20 |
| 3 | Safety of epinephrine for anaphylaxis in the emergency setting显示文摘BACKGROUND:While epinephrine is the recommended first-line therapy for the reversal of anaphylaxis symptoms,inappropriate use persists because of misunderstandings about proper dosing and administration or misconceptions about its safety.The objective of this review was to evaluate the safety of epinephrine for patients with anaphylaxis,including other emergent conditions,treated in emergency care settings.METHODS:A MEDLINE search using PubMed was conducted to identify articles that discuss the dosing,administration,and safety of epinephrine in the emergency setting for anaphylaxis and other conditions.RESULTS:Epinephrine is safe for anaphylaxis when given at the correct dose by intramuscular injection.The majority of dosing errors and cardiovascular adverse reactions occur when epinephrine is given intravenously or incorrectly dosed.CONCLUSION:Epinephrine by intramuscular injection is a safe therapy for anaphylaxis but training may still be necessary in emergency care settings to minimize drug dosing and administration errors and to allay concerns about its safety. | Joseph P Wood Stephen J Traub Christopher Lipinski | 2013 | World Journal of Emergency Medicine2013，4，4： | 7 |
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