上消化道出血病因及发病趋势分析

Etiology and Incidence Tendency of Upper Gastrointestinal Bleeding

目的:探讨近10年来上消化道出血(upper gastrointestinal bleeding,UGB)的病因构成、发病趋势及与几个相关因素的关系。方法:对我院1993、1998和2003年间经内镜检查的UGB住院病人的临床资料进行统计分析。结果:(1)共检出UGB 2 347例,1993年580例、1998年646例、2003年1 121例。(2)消化性溃疡、急性胃粘膜病变、胃癌为UGB常见病因,分别占27.8%、21.1%、9.4%。(3)1993、1998和2003年三个年份中,急性胃粘膜病变分别占该年份UGB的24.3%、23.8%、17.9%;胃溃疡分别占8.3%、7.3%、4.5%;胃癌分别占6.0%、7.7%、12.0%;十二指肠溃疡分别占13.1%、19.8%、27.0%。(4)男性患者明显多于女性,男女之比为2.11∶1。(5)随着年龄的增长,UGB的发病例数增加。(6)冬春两季的发病例数明显多于夏秋两季。结论:消化性溃疡是UGB的主要原因,其次是急性胃粘膜病变、胃癌。急性胃粘膜病变、胃溃疡的发病构成比呈下降趋势,差异有统计学意义(P<0.01),胃癌、十二指肠溃疡的发病构成比呈上升趋势,差异有统计学意义(P=0.000)。UGB的病因分布与性别、年龄、季节、年代变化等因素相关。

Objective：To investigate the causes, the incidence tendency and some relative factors of upper gastrointestinal bieeding（UGB） in the last ten years. Methods：Endoscopy was performed in the adults hospitalized for UGB in 1993,1998 and 2003. Results： （1）2347 UGB inpatients were enrolled in this study. There were 580 patients in 1993, 646 in 1998, and 1121 in 2003. （2）The most common causes of UGB were peptic ulcer （27.8%）, AGML （21. 1%）, and gastric cancer （9.4%）. （3）The rates of AGML were 24.3% in 1993, 23.8% in 1998, and 17.9% in 2003 respectively; those of gastric ulcer were 8. 28%, 7. 28%, and 4. 46%; of gastric cancer were 6.03%,7.74%, 12. 04%, and of duodenal ulcer were 13. 1%,19.8%,27. 0%, respectively in 1993, 1998, and 2003. （4）The male patients were more than female patients significantly. The ratio of male to female patients was 2. 11：1. （5）The UGB patients increased with age. （6）The UGB patients in winter and spring were more than that in summer and autumn. Conclusion：The most common causes of UGB were peptic ulcer, AGML, and gastric cancer. In different years, the incidences of gastric ulcer and AGML had a tendency of yearly decreasing （P〈0.01）. The incidences of duodenal ulcer and gastric cancer had a tendency of increasing （P=0. 000）. Sex, age, weather alteration, and change of time were all correlative factors involved in the occurrence of UGB.