Retrospective study on 42 patients of cushing ulcer with bleeding in the first symptom of hiccup

doi:10.3877/cma.j.issn.2096-1537.2019.04.007

Abstract

Abstract:

Objective

To explore whether it is worthy of clinical attention of hiccup can be regarded as the first symptom of Cushing ulcer with bleeding or not.

Methods

A retrospective study of 42 cases with Cushing ulcer and bleeding as the first symptom of hiccup was given to analyze the relationship between the first appearance time of hiccup and the first 24 h gastrointestinal decompression drainage, compare the difference in duration of hemorrhage, incidence of hemodynamic instability, and mortality between patients who received comprehensive therapy within 1 h and those who received more than 1 h of treatment.

Results

There was a correlation between the first appearance of hiccup and the gastrointestinal decompression drainage within the first 24 h (pearson correlation coefficien r=-0.802). The group of intervention within 1 h had shorter duration of bleeding, lower incidence of hemodynamic instability and mortality (P<0.05).

Conclusion

The first moment of hiccup has a negative correlation with gastrointestinal decompression and drainage volume within 24 h, the diagnosis of Cushing ulcer combined with hemorrhage within 1 h of hiccup occurres, and timely comprehensive treatment is more beneficial for patients.

Key words: Stress ulcer, Cushing ulcer, Hiccup

Peng Che, Yugang Wang, Taoning Wang. Retrospective study on 42 patients of cushing ulcer with bleeding in the first symptom of hiccup[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(04): 330-333.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2019.04.007

https://icu.cma-cmc.com.cn/EN/Y2019/V05/I04/330

Figures/Tables 2

References 14

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一般资料		1 h内治疗组（21例）	超过1 h治疗组（21例）	对照组（21例）
性别（男/女，例）		13/8	11/10	15/6
年龄（岁，±s）		37±13	34±16	38±10
疾病分类（例）
	重型颅脑损伤	11	11	0
	脑出血	6	6	0
	颅内占位术后	8	8	0
	胃溃疡	0	0	11
	十二指肠溃疡	0	0	6
	复合溃疡	0	0	8
意识状态		昏迷	昏迷	清醒或嗜睡
首发症状		呃逆	呃逆	呃逆
呃逆首次出现时间（d，±s）		4.12±1.27	4.44±1.53	2.46±1.53
发病前合并肺部感染（例）		4	5	1
发病前末梢循环状况		良好	良好	良好
发病前皮肤色泽		红润或正常	红润或正常	红润或正常
发病前血常规
	血红蛋白（男/女，g/L，±s）	132±25/124±21	126±25/120±22	130±22/119±18
	红细胞计数（男/女，×10¹²/L，±s）	4.6±0.8/3.8±0.4	4.4±0.8/3.4±0.3	4.5±0.6/3.6±0.2
	血细胞比容（男/女，%，±s）	43±6/35±7	42±7/36±5	43±6/35±5
发病后收缩压（mmHg，±s）		128±21	118±15	121±17
发病后胃肠减压后引流物颜色		咖啡色或暗红色	咖啡色或暗红色	-
第1个24 h胃肠减压引流量（ml，±s）		263±115	255±128	-
发病后粪便潜血实验		阳性	阳性	阴性
发病后血常规
	血红蛋白（男/女，g/L，±s）	108±22/97±19	111±25/101±21	130±20/119±18
	红细胞计数（男/女，×10¹²/L，±s）	4.0±1.2/3.3±0.3	4.1±0.6/3.1±0.2	4.5±0.9/3.6±0.3
	血细胞比容（男/女，%，±s）	37±5/32±4	43±6/35±7	41±7/33±5
	发病后当天胃液pH	3.2±0.9	3.4±1.1	1.2±0.5
发病后当天尿素氮（mmol/L，±s）		15.5±2.5	16.4±3.1	7.5±2.3
发病后当天随机血糖（mmol/L，±s）		8.9±1.9	10.9±1.6	8.3±2.1
出血持续时间（d，±s）		4.3±1.6	7.4±2.1	-

一般资料		1 h内治疗组（21例）	超过1 h治疗组（21例）	对照组（21例）
性别（男/女，例）		13/8	11/10	15/6
年龄（岁，±s）		37±13	34±16	38±10
疾病分类（例）
	重型颅脑损伤	11	11	0
	脑出血	6	6	0
	颅内占位术后	8	8	0
	胃溃疡	0	0	11
	十二指肠溃疡	0	0	6
	复合溃疡	0	0	8
意识状态		昏迷	昏迷	清醒或嗜睡
首发症状		呃逆	呃逆	呃逆
呃逆首次出现时间（d，±s）		4.12±1.27	4.44±1.53	2.46±1.53
发病前合并肺部感染（例）		4	5	1
发病前末梢循环状况		良好	良好	良好
发病前皮肤色泽		红润或正常	红润或正常	红润或正常
发病前血常规
	血红蛋白（男/女，g/L，±s）	132±25/124±21	126±25/120±22	130±22/119±18
	红细胞计数（男/女，×10¹²/L，±s）	4.6±0.8/3.8±0.4	4.4±0.8/3.4±0.3	4.5±0.6/3.6±0.2
	血细胞比容（男/女，%，±s）	43±6/35±7	42±7/36±5	43±6/35±5
发病后收缩压（mmHg，±s）		128±21	118±15	121±17
发病后胃肠减压后引流物颜色		咖啡色或暗红色	咖啡色或暗红色	-
第1个24 h胃肠减压引流量（ml，±s）		263±115	255±128	-
发病后粪便潜血实验		阳性	阳性	阴性
发病后血常规
	血红蛋白（男/女，g/L，±s）	108±22/97±19	111±25/101±21	130±20/119±18
	红细胞计数（男/女，×10¹²/L，±s）	4.0±1.2/3.3±0.3	4.1±0.6/3.1±0.2	4.5±0.9/3.6±0.3
	血细胞比容（男/女，%，±s）	37±5/32±4	43±6/35±7	41±7/33±5
	发病后当天胃液pH	3.2±0.9	3.4±1.1	1.2±0.5
发病后当天尿素氮（mmol/L，±s）		15.5±2.5	16.4±3.1	7.5±2.3
发病后当天随机血糖（mmol/L，±s）		8.9±1.9	10.9±1.6	8.3±2.1
出血持续时间（d，±s）		4.3±1.6	7.4±2.1	-

组别	例数	出血持续时间（d，±s）	血流动力学不稳定［例（%）］	病死［例（%）］
1 h内治疗组	21	4.3±1.6	4（19.0）	1（0.5）
超过1 h治疗组	21	8.4±2.5^a	8（38.1）^a	3（14.3）^b

组别	例数	出血持续时间（d，±s）	血流动力学不稳定［例（%）］	病死［例（%）］
1 h内治疗组	21	4.3±1.6	4（19.0）	1（0.5）
超过1 h治疗组	21	8.4±2.5^a	8（38.1）^a	3（14.3）^b

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