Effect of emergency fast-track treatment on dangerous upper gastrointestinal bleeding_West China Medical Journal

Authors：

XU Pengjie ¹ , WU Xiaoling ² , XU Guisen ¹ , XU Zhaoxia ¹ ,  WANG Ping ¹

1. Department of Emergency, the General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P. R. China;
2. Department of Gastroenterology, the General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P. R. China;

Corresponding author：

WANG Ping, Email: 282210437@qq.com

Keywords：

Dangerous upper gastrointestinal bleeding; fast-track treatment; multidisciplinary therapy

DOI：

10.7507/1002-0179.202112127

Video：

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Objective To investigate the effect of emergency fast-track treatment on dangerous upper gastrointestinal bleeding. Methods Seventy-six patients who received traditional treatment between October 2020 and March 2021 were included in the traditional treatment group, and 82 patients who entered the emergency fast track for dangerous upper gastrointestinal bleeding between April 2021 and September 2021 were included in the fast-track treatment group. The patients in the traditional treatment group were treated with the traditional single-subject diagnosis and treatment mode, and the patients in the fast-track treatment group were treated according to the multidisciplinary diagnosis and treatment procedures of emergency fast track for dangerous upper gastrointestinal bleeding. The length of emergency stay, 24-hour endoscopic completion rate, effective rate, and length of hospital stay were compared between the two groups. Results The length of emergency stay [(3.75±3.19) vs. (6.51±4.72) h], the effective rate (96.3% vs. 85.5%) and the length of hospital stay [(8.26±2.51) vs. (11.07±2.79) d] were significantly better in the fast-track group than those in the traditional treatment group (P<0.05). There was no significant difference in the 24-hour endoscopic completion rate between the two groups (96.3% vs. 96.1%, P>0.05). Conclusion Compared with the traditional treatment mode, the fast-track treatment mode can significantly improve the treatment efficiency, and reduce the lengths of emergency stay and hospital stay.

Citation： XU Pengjie, WU Xiaoling, XU Guisen, XU Zhaoxia, WANG Ping. Effect of emergency fast-track treatment on dangerous upper gastrointestinal bleeding. West China Medical Journal, 2022, 37(11): 1636-1640. doi: 10.7507/1002-0179.202112127 Copy

1.	Antunes C, Copelin IE. Upper gastrointestinal bleeding. Treasure Island (FL): StatPearls Publishing, 2020.
2.	中国医师协会急诊医师分会, 中华医学会急诊医学分会, 全军急救医学专业委员会, 等. 急性上消化道出血急诊诊治流程专家共识. 中国急救医学, 2021, 41(1): 1-10.
3.	胡佳辰. 危险性消化道出血的急诊临床诊治与临床思维. 中国急救医学, 2017, 37(5): 467-471.
4.	Laursen SB, Dalyon HR, Murray IA, et al. Performance of new thresholds of the Glasgow Blatchford score in managing patients with upper gastrointestinal bleeding. Clin Gastroenterol Hepatol, 2015, 13(1): 115-121.
5.	李玥, 胡祥鹏, 章礼久. 三种内镜前评分系统对危险性急性上消化道出血预后评估的比较. 蚌埠医学院学报, 2022, 47(8): 1026-1029.
6.	杜小芳, 何旭. 不同年龄上消化道出血的临床特征及其危险因素比较分析. 内蒙古医科大学学报, 2021, 43(1): 62-64, 81.
7.	《中华内科杂志》, 《中华医学杂志》, 《中华消化杂志》, 等. 急性非静脉曲张性上消化道出血诊治指南(2018 年,杭州). 中华消化内镜杂志, 2019, 36(2): 77-85.
8.	岳佳琪, 李莉, 陈迹. 艾司奥美拉唑钠治疗上消化道出血的成本-效果分析. 西北药学杂志, 2021, 36(6): 1009-1012.
9.	董丽丽, 周荣斌. 急性上消化道出血救治研究现状. 中国实用内科杂志, 2021, 41(3): 203-208.
10.	李心群, 陈心怡, 王欣璐, 等. 危险性上消化道出血患者病情严重程度危险因素分析及预警评估模型构建. 中华急诊医学杂志, 2022, 31(4): 539-543.
11.	乔丽, 程绩, 郑晖, 等. 基于倾向性评分匹配分析急诊快速通道救治急性上消化道出血的疗效. 中国急救医学, 2022, 42(4): 326-330.
12.	李福娥. 优化急诊护理流程在危险性急性上消化道出血中的应用. 实用中西医结合临床, 2020, 20(7): 134-135.
13.	张朝辉, 严晶晶. 危险性上消化道出血多学科协作诊疗模式与传统会诊模式临床疗效的对照研究. 中华危重病急救医学, 2020, 32(9): 1107-1110.
14.	涂家红, 张明清, 赵斌. 危险性急性上消化道出血 141 例临床诊治分析. 中华急诊医学杂志, 2018, 27(5): 518-523.
15.	Barkun AN, Almadi M, Kuipers EJ, et al. Management of non-variceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med, 2019, 171(11): 805-822.
16.	Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ, 2019, 364: 1536.
17.	周未, 樊丽珍, 杨保元, 等. 急诊胃镜微创治疗消化道大出血 219 例分析. 中国药物与临床, 2020, 20(12): 1975-1977.
18.	Jeong N, Kim KS, Jung YS, et al. Delayed endoscopy is associated with increased mortality in upper gastrointestinal hemorrhage. Am J Emerg Med, 2019, 37(2): 277-280.
19.	Tandberg DJ, Smith TP, Suhocki PV, et al. Early outcomes of empiric embolization of tumor-related gastrointestinal hemorrhage in patients with advanced malignancy. J Vasc Interv Radiol, 2012, 23: 1445-1452.
20.	杨丽. 急性上消化道大出血介入治疗现状. 四川大学学报(医学版), 2022, 53(3): 361-366.

1. Antunes C, Copelin IE. Upper gastrointestinal bleeding. Treasure Island (FL): StatPearls Publishing, 2020.
2. 中国医师协会急诊医师分会, 中华医学会急诊医学分会, 全军急救医学专业委员会, 等. 急性上消化道出血急诊诊治流程专家共识. 中国急救医学, 2021, 41(1): 1-10.
3. 胡佳辰. 危险性消化道出血的急诊临床诊治与临床思维. 中国急救医学, 2017, 37(5): 467-471.
4. Laursen SB, Dalyon HR, Murray IA, et al. Performance of new thresholds of the Glasgow Blatchford score in managing patients with upper gastrointestinal bleeding. Clin Gastroenterol Hepatol, 2015, 13(1): 115-121.
5. 李玥, 胡祥鹏, 章礼久. 三种内镜前评分系统对危险性急性上消化道出血预后评估的比较. 蚌埠医学院学报, 2022, 47(8): 1026-1029.
6. 杜小芳, 何旭. 不同年龄上消化道出血的临床特征及其危险因素比较分析. 内蒙古医科大学学报, 2021, 43(1): 62-64, 81.
7. 《中华内科杂志》, 《中华医学杂志》, 《中华消化杂志》, 等. 急性非静脉曲张性上消化道出血诊治指南(2018 年,杭州). 中华消化内镜杂志, 2019, 36(2): 77-85.
8. 岳佳琪, 李莉, 陈迹. 艾司奥美拉唑钠治疗上消化道出血的成本-效果分析. 西北药学杂志, 2021, 36(6): 1009-1012.
9. 董丽丽, 周荣斌. 急性上消化道出血救治研究现状. 中国实用内科杂志, 2021, 41(3): 203-208.
10. 李心群, 陈心怡, 王欣璐, 等. 危险性上消化道出血患者病情严重程度危险因素分析及预警评估模型构建. 中华急诊医学杂志, 2022, 31(4): 539-543.
11. 乔丽, 程绩, 郑晖, 等. 基于倾向性评分匹配分析急诊快速通道救治急性上消化道出血的疗效. 中国急救医学, 2022, 42(4): 326-330.
12. 李福娥. 优化急诊护理流程在危险性急性上消化道出血中的应用. 实用中西医结合临床, 2020, 20(7): 134-135.
13. 张朝辉, 严晶晶. 危险性上消化道出血多学科协作诊疗模式与传统会诊模式临床疗效的对照研究. 中华危重病急救医学, 2020, 32(9): 1107-1110.
14. 涂家红, 张明清, 赵斌. 危险性急性上消化道出血 141 例临床诊治分析. 中华急诊医学杂志, 2018, 27(5): 518-523.
15. Barkun AN, Almadi M, Kuipers EJ, et al. Management of non-variceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med, 2019, 171(11): 805-822.
16. Stanley AJ, Laine L. Management of acute upper gastrointestinal bleeding. BMJ, 2019, 364: 1536.
17. 周未, 樊丽珍, 杨保元, 等. 急诊胃镜微创治疗消化道大出血 219 例分析. 中国药物与临床, 2020, 20(12): 1975-1977.
18. Jeong N, Kim KS, Jung YS, et al. Delayed endoscopy is associated with increased mortality in upper gastrointestinal hemorrhage. Am J Emerg Med, 2019, 37(2): 277-280.
19. Tandberg DJ, Smith TP, Suhocki PV, et al. Early outcomes of empiric embolization of tumor-related gastrointestinal hemorrhage in patients with advanced malignancy. J Vasc Interv Radiol, 2012, 23: 1445-1452.
20. 杨丽. 急性上消化道大出血介入治疗现状. 四川大学学报(医学版), 2022, 53(3): 361-366.

West China Medical Journal

Effect of emergency fast-track treatment on dangerous upper gastrointestinal bleeding

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