老年上消化道出血的病因分析与幽门螺杆菌感染情况调查

目的了解湛江地区老年人上消化道出血的病因和幽门螺杆菌感染的情况。方法对536例60岁以上老年人上消化道出血患者在出血后24～72h内进行胃镜检查、同时取活检组织作病理诊断和HP检测。并分别与同期60岁以上非出血组和59岁以下组做对比。结果胃镜所见老年人上消化道出血的536例中,十二指肠溃疡186例,居于首位,其次为胃溃疡132例、急性胃粘膜病变53例、胃癌45例。本组HP阳性率为33.9%,与同期60岁以上非出血组及59岁以下组(不分出血与否)比较均有显著性差异(P<0.01)。结论老年人上消化道出血仍以消化性溃疡为多见,且消化道肿瘤相对较多,值得重视。本组HP阳性率比同期60岁以上非出血组和59岁以下组均低,其原因未明。急诊胃镜检查对老年上消化道出血,既可快速明确诊断,又可配合内科治疗,值得提倡。

Objective To understand the cause of upper gastrointestinal hemorrhage of elderly people in Zhanjiang area and situation of herlicobacter Pylori（HP） infection. Methods.The upper gastrointestinal hemorrhage of 536 elderly patients 24-72 hours after bleeding were carried out gastroscopy inspection and took the biopsy organization to make the pathological diagnosis and the HP examination,and the non-hemorrhage group over 60 years old and below 59 years old the group were as the control at the same time. Results Of 536 patients, 536 were diagnosed with upper gastrointestinal hemorrhage. Duodenal ulcer was 186 cases, which ranked the first,gastric ulcer 132 cases,acute gastric mucosal lesion 53cases,stomach cancer 45 cases.This group of HP masculine gender rate was 33.9%,The positive rate of H.pylori in this group was significantly different from non- hemorrhage group over 60 and group below 59 （hemorrhage or not） during the same time. Conclusion Peptic ulcer is the most common reason of upper gastrointestinal hemorrhage in the elderly ,and digestive tract cancer is also relatively common, it is worthy of mentionging. This positive rate of liP infection lowed than m non-hemorrhage group 60 years old above and 59 years old group 1 （P〈0.01）,its reason is not bright.Emergency gastrocope is helpful to quickly diagnose of upper gastrointestinal hemorrhage in the elderly and medical treatment and should be advocated.