220例中年人上消化道出血病因分析与治疗

Contrast Study of the Causes of Upper Gastrointestinal Bleeding and the Different Therapeutic Effectiveness in 220 Middle-aged Patients

目的探讨中年人上消化道出血的病因与疗效。方法回顾性分析220例中年人上消化道出血患者的临床资料,与同期接受治疗的180例老年上消化道出血患者比较病因与治疗结果。结果中年人及老年人上消化道出血的最常见病因均为消化性溃疡。食管静脉曲张破裂出血、急性糜烂出血性胃炎的发病中年人组高于老年人组,胃癌发病低于老年人组。质子泵抑制剂奥美拉唑对非食管静脉曲张破裂出血患者效果优于H2受体拮抗剂法莫替丁(P<0.05);生长抑素及其类似物对食管胃底静脉曲张破裂出血的疗效优于垂体后叶素。结论早期内镜检查有助于早期诊断并指导治疗;针对非静脉曲张破裂出血患者应首选PPIs,食管胃底静脉曲张破裂出血治疗上首选生长抑素及其类似物。

Objective To investigate the causes of upper gastrointestinal bleeding and the different therapeutic effectiveness in middle-aged patients. Methods Comparing the causes and the therapeutic effectiveness of upper gastrointestinal bleeding between 220 middle-aged pa- tients and 180 old patients. Results The most causes in middle-aged patients who sufferring upper gastrointestinal bleeding was PU. There was a higher incidence of esophageal gastric fundus variceal bleeding and acute erosive-hemorrhagic gastritis in middle-aged patients. On the other hand a incidence rate of gastric cancer in the same groups. Omeprazole was more effective in treating non-esophageal-gastric fundus variceal bleeding than famotidine（P 〈 0.05 ）. Sandostatin was more effect and had less side in treating esophageal gastric fundus variceal bleeding than hypophysin. Conclusion An early endoscopy examination can get an early diagnosis to therapy it immediately. The superior medicine to treat esophageal-gastric fundus variceal bleeding is somatostatin or sandostatin and omeprazole is to non-esophageal-gastric fnndus varieeal bleeding.