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출혈성 소화성 궤양 환자에서 재출혈의 위험인자 및 재출혈률
서승원(Seung Won Seo),김연수(Yeon Soo Kim),문희석(Hee Seok Mun),박기오(Ki Ho Park),이엄석(Eom Seok Lee),김선문(Seon Mun Kim),양현웅(Hyeon Woong Yang),나병규(Byung Kyu La),성재규(Jae Kyu Seong),이병석(Byung Seok Lee),정현용(Hyun Yong 대한소화기학회 2002 대한소화기학회지 Vol.39 No.2
Background/Aims: Bleeding from peptic ulcer is a common and serious complication. Endoscopic therapy is effective in hemostasis of active bleeding. However, rebleeding occurs in 10-30% of patients with bleeding peptic ulcer, and is an important factor associated with mortality. In this study, we analyzed risk factors and rate of rebleeding in patients with bleeding peptic ulcer. Methods: We analyzed 194 patients with peptic ulcer bleeding between June 1995 and May 1998. We retrospectively analyzed the rebleeding risk factors by reviewing medical records and telephone interviews. Results: Rebleeding of peptic ulcer occurred in 43 patients (22.2%). Cumulative rebleeding rate was 12.1% after 1 month, 15.2% after 6 months. The cumulative rebleeding rates at 1, 2, and 3 years were 16.2%, 19.4% and 20.9%, respectively. On the basis of an univariate analysis of clinical and endoscopic findings, significant predictive factors for rebleeding were history of peptic ulcer bleeding (p=0.002), use of NSAIDs (p=0.08), endoscopic stigmata of recent hemorrhage (p=0.000), and presence of shock (p=0.002). In multivariate analysis, history of peptic ulcer bleeding (odds ratio, OR=9.12), use of NSAIDs (OR=7.91), endoscopic stigmata of recent hemorrhage (OR=0.37), and presence of shock (OR=3.83) were independent risk factors of rebleeding. Conclusions: Rebleeding rate of peptic ulcer is 20.6% during 3 years of follow-up and important risk factors of rebleeding are history of peptic ulcer bleeding, use of NSAIDs, endoscopic stigmata of recent hemorrhage, and presence of shock. (Korean J Gastroenterol 2002;39:101-107)
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