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긴급 내시경검사에 의한 상부 위장관 출혈의 임상적 고찰
송관석(Gwan Seok Song),안혜진(Hea Jin An),김걸(Geol Kim),최일균(Il Kun Choi),최조영(Jo Young Choi),곽정재(Jeong Jae Gwak),이상용(Sang Yong Lee) 대한내과학회 1988 대한내과학회지 Vol.35 No.2
N/A Upper gastrointestinal tract bleeding has been a common clinical problem for several decades with a relatively high mortality rate. According to the literature the cause and nature of such bleeding is controversial despite the improved diagnostic procedure and treatment method available today. Emergency endoscopy was performed in patients with upper gastrointestioal tract bleeding for a 6year period, from Jan. 1982 to Dec. 1987, at Incheon Christian Hospital. The following results were obtained: 1) The ratio of male to female patients was 3.4:1 2) The age distribution revealed that the peak incidence of bleeding occured in the 5th decade of life. 3) The causative diseases were in the order of frequency of gastric ulcer (28.6%), duodenal ulcer(24.4%), eso. varices (16.8%),erosive gastritis (13.8%) and gastric ca. (8.2%). 4) The mode of bleeding was hematemesis in 27% of the cases, melena in 29%, and mixed type in 44/o. 5) According to Palumbo classification, the severity of bleeding was mimmal in 35.7% of the cases, moderate in 43.9% and massive in 30.4%. 6) Blood transfusions were done in 145 cases (74% of all cases). Of these, 1-5 pints were given in 43% of the cases, 6-10 pints pints in 18%, and more than 26 pints in 0.5%. Blood transfusions were not given in 26% of all cases. 7) Of the 196 ca the time of endoscopic examination after the episode of bleeding was within 6hr in 33 cases(16.8%), within 6-12hr in 46 cases (23.5%), within 12-24hr in 53 cases(27%) and within 24-36hr in 28 cases(14.3%). In total, 67,3% of the cases were examined within 24hr and 95.4% within 48hr. 8) The state of the lesions upon endoscopic examination was active bleeding in (39 cases) 19.9%, recent bleeding in 90 cases(46%), lesion only in 63 cases(32.1%), and no lesions were found in 4 cases(2%). 9) The treatment consisted of medical and surgical methods; medical in 86.2% of the cases and surgical in 13.8%. 10) The overall mortality was 9.7%.
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