Objective:To investigate the relationship between previous bleeding history and poor prognosis of patients with acute upper gastrointestinal bleeding.Methods:This study was a prospective multicentre real-world study (Acute Upper Gastrointestinal Real-word study, AUGUR study). The data of patients with UGIB who were admitted to the emergency department of 20 tertiary hospitals in China from June 30, 2020 to February 10, 2021 were collected. According to the number of previous bleeding history, the patients were divided into three groups (0 time, 1-3 times, and≥4 times). Based on the patient’s demographic data, clinical characteristics, laboratory data, treatment, and outcomes, univariate and logistic regression analysis were performed to investigate the correlation between the number of previous bleeding and the 90-day mortality and rebleeding of patients with gastrointestinal bleeding.Results:A total of 1 072 patients with acute UGIB were included in this study. The all-cause mortality and rebleeding rate of all patients were 10.9% (117/1 072) and 11.8% (129/1 072), respectively. Among them, 712 patients (66.42%) had no previous bleeding, 297 patients (27.71%) had previous bleeding 1-3 times, and 63 patients (5.88%) had previous bleeding≥4 times. In univariate analysis, age, vital signs and consciousness on admission, history of liver cirrhosis, onset with hematemesis, admission hemoglobin, varicose veins bleeding, peptic ulcer bleeding, red blood cell infusion, tracheal intubation and the use of vasopressors after admission were risk factors for the 90-day mortality and rebleeding rate. Multivariate logistic regression analysis showed that patients with previous bleeding≥4 times had a higher risk of the 90-day mortality ( OR=2.17, 95% CI: 1.04-4.57, P=0.040) and rebleeding ( OR=2.32, 95% CI: 1.19-4.53, P=0.013). Conclusions:The history of previous bleeding≥ 4 times can be used as an independent risk factor for the 90-day mortality and rebleeding in patients with acute UGIB.

目的探讨经股动脉和桡动脉途径行冠状动脉造影(CAG)和冠状动脉介入治疗(PCI)的可行性、安全性、优缺点。方法395例冠心病住院患者分别接受经股动脉(F)组(n=188)或经桡动脉(A)组(n=207)途径行冠心病介入诊疗,观察两组的手术成功率、手术时间、并发症发生率、X线曝光时间、住院时间。结果CAG手术成功率:A组成功率91.8%,F组成功率99.5%,股动脉成功率高于前者,差异有统计学意义;两组患者PCI手术成功率、手术时间、X线曝光时间差异无统计学意义,但A组穿刺部位并发症发生率、住院时间低于F组,差异有统计学意义。结论经桡动脉途径行冠心病介入诊疗是一种安全、有效和可行的方法,可有效地减少穿刺部位并发症的发生,易被患者接受,但需要介入医生更多的技巧和更长的学习曲线。

目的 探讨经股动脉和桡动脉途径行冠状动脉造影(CAG)和冠状动脉介入治疗(PCI)的可行性、安全性、优缺点.方法 395例冠心病住院患者分别接受经股动脉(F)组(n=188)或经桡动脉(A)组(n=207)途径行冠心病介入诊疗,观察两组的手术成功率、手术时间、并发症发生率、X线曝光时间、住院时间.结果 CAC手术成功率:A组成功率91.8%,F组成功率99.5%,股动脉成功率高于前者,差异有统计学意义;两组患者PCI手术成功率、手术时间、X线曝光时间差异无统计学意义,但A组穿刺部位并发症发生率、住院时间低于F组,差异有统计学意义.结论 经桡动脉途径行冠心病介入诊疗是一种安全、有效和可行的方法,可有效地减少穿刺部位并发症的发生,易被患者接受,但需要介入医生更多的技巧和更长的学习曲线.