老年人上消化道出血296例病因及相关因素分析

Analysis Etiological and Related Factor of Upper Gastrointestinal Bleeding in 296 Aged Patients

目的 :了解老年人上消化道出血的病因及其相关因素。方法 :博罗县人民医院 1992年 1月 2 0 0 3年 12月 2 96例上消化道出血老年人患者 ,符合入选标准 ,按时期分为前 6年和后 6年分别分析其临床资料。结果 :出血的原因为急性胃粘膜病变 (10 2 /2 96 ,34.4 6 % ) ,胃溃疡 (78/2 96 ,2 6 .35 % ) ,十二指肠溃疡 (49/2 96 ,16 .5 5 % ) ,复合性溃疡(11/2 96 ,3.72 % ) ,食管胃底静脉曲张 (16 /2 96 ,5 .4 1% ) ,胃恶性肿瘤 (12 /2 96 ,4 .0 5 % ) ,胃息肉 (4/2 96 ,1.35 % ) ,食管贲门粘膜撕裂 (6 /2 96 ,2 .0 3% ) ,不明原因 (18/2 96 ,6 .0 8% ) ;引起出血的病因中 ,后 6年急性胃粘膜病变和胃溃疡均高于前 6年 ,两者相比差异具有显著性。急性胃粘膜病变和胃溃疡的出血与长期小剂量服用非甾体抗炎药(NSAID)或短期大剂量服用NSAID有关。结论 :急性胃粘膜病变 ,胃溃疡 ,十二指肠溃疡是老年人消化道出血的主要原因 ;对患有冠心病 ,脑血管疾病需要服用NSAID的患者 。

Objective:To investigate the etiology of upper gastrointestinal bleeding in aged patients.Methods: Two hundred ninety six elder with upper gastrointestinal bleeding in the People’s Hospital of Boluo County during January 1992 to December 2003 were enrolled and studied retrospectively.Results: Causes of bleeding were acute gastric mucosal injury (102/296,34.46%), gastric ulcer (78/296,26.35%), duodenal ulcer (49/296,16.55%), complex ulcer (11/296, 3.72%), esophageal or gastric varicosity (16/296,5.41%), gastric malignant tumors (12/296, 4.05%), gastric polyp (4/296,1.35%), Mallory-Weiss tear (6/296,2.03%), no lesion identified (18/296,6.08%).The prevalence rate of acute gastric mucosal injury and gastric ulcer had increasing tendency in the latest 6 years compared with that in the period before the 6 years.The bleeding caused by acute gastric mucosal injury and gastric ulcer had relationship with long-term low-dose or short-term large-dose NSAID administration.Conclusion: Principal causes of bleeding were acute gastric mucosal injury, gastric ulcer, duodenal ulcer. For patients taking NSAID to treat coronary heart disease or cerebrovascular disease, it is important to protect their gastric mucosa.