Abstract:

Objective To investigate the application effect of graded intervention based on Rockall risk score in patients with acute non-variceal upper gastrointestinal bleeding （ANVUGIB）. Methods A total of 218 patients with ANVUGIB admitted to the hospital between January 2021 and January 2025 were selected， and randomly assigned to the study group （n = 110） and the control group （n = 108）. The control group received conventional treatment and intervention measures. On this basis， the study group was given graded intervention based on Rockall risk score. Comparisons were made between the two groups on rebleeding rates under different Rockall risk levels， hemoglobin （Hb） levels， platelet count （PLT）， clinical symptom improvement time， ANVUGIB self-management scores， Self-Rating Anxiety Scale （SAS） and Self-Rating Depression Scale （SDS） scores， and clinical outcomes. Results After intervention， the rebleeding rates of patients at intermediate Rockall risk and high risk in the study group （12.90% and 17.65%） were lower than those in the control group （28.57% and 53.85%） （P < 0.05）. The total rebleeding rate in the study group （10.00%） was lower than that in the control group （25.93%） （P < 0.05）. After 1 week and 1 month of intervention， Hb levels and PLT in the study group were higher than those in the control group （P < 0.05）. The time to stopping bleeding， hematemesis or melena disappearing， blood pressure returning to normal， and heart rate returning to normal was shorter in the study group than in the control group （P < 0.05）. After 1 week and 1 month of intervention， ANVUGIB self-management scores of the study group were higher than those of the control group. The SAS and SDS scores were lower than those of the control group （P < 0.05）. The blood transfusion rate and complication rate during hospitalization were comparable between the two groups of patients （P > 0.05）. Hospital stay of the study group was shorter than that of the control group （P < 0.05）. Conclusion Graded intervention based on Rockall risk score can improve bleeding symptoms， reduce rebleeding rate， enhance self-management ability， alleviate anxiety， and improve clinical outcomes in patients with ANVUGIB.

Key words: acute non variceal upper gastrointestinal bleeding, Rockall risk score, graded intervention, bleeding again, self-management