79例老年上消化道出血临床分析

The Clinic Study on 79 Cases of Elderly Upper Gastrointestinal Tract Bleeding

目的 :探讨老年上消化道出血的原因和不同制酸剂对出血的治疗效果。方法 :对我院 1998年 1月至2 0 0 4年 6月共 79例老年上消化道出血患者的临床资料进行回顾性分析。男 4 5例 ,女 34例 ,年龄 6 0～ 85岁 ,平均 6 7 6岁 ,患者被随机分为两组分别接受洛赛克和法莫替丁治疗。统计治疗 3天的总有效率和引起出血的原发疾病百分比。结果 :引起出血的原发疾病中 ,胃、十二指肠溃疡 30例 (38 0 %) ,胃黏膜病变 2 8例 (35 4 %) ,门静脉高压症并发食管静脉曲张破裂出血 14例 (17 7%) ,上消化道肿瘤 5例 (6 3%) ,其他 2例 (2 5 %)。洛赛克组总有效率 95 2 %,法莫替丁组总有效率 78 4 %(P <0 0 5 )。结论 :老年上消化道出血主要由胃、十二指肠溃疡和胃黏膜病变引起。质子泵抑制剂洛赛克治疗老年上消化道出血疗效显著。

Objective： Clinieal analysis of the elderly upper gastrointestinal bleeding. Methods： From January 1998 to June 2004, 79 elderly upper gastrointestinal bleeding diagnosed by endoseopy and clinical presentation were studied. Group Losee 42 eases were treated with Losee 40 mg Ⅳ q12h, and group Famofidine 37 eases were treated 20 mg IV drop bid. The course of therapy was 3 days. The total effective rate and cause of ehterly upper gastrointestinal bleeding were recorded. Results： Among primary diseases causing elderly upper gastrointestinal traet bleeding, 30 eases （38%） were gastric aleer and duodenal uleer, 28 cases （35.4%） were stomach mucous membrane pathologieal change, 14 eases （ 17.7 % ） were rupture of esophageal variees by Portal hypertension, 5 eases （6.3%） were upper gastrointestinal tract rumor, and 2 cases （2.5%） were other diseases. The total effective rote in group Losee and Famotidine were 95.2% and 78.4% （ P 〈 0.05）. Conclusions： Elderly upper gastrointestinal bleeding were mainly caused by gastric and duodenal ulcer and gastric mucous lesions. Proton pump inhibitor （PPI） Losee seems to be the best medication for the elderly upper gastrointestinal bleeding.