82例老年人急性非静脉曲张性上消化道出血临床分析

Clinical characteristics of acute nonvariceal upper gastrointestinal bleeding in 82 elderly patients

目的:分析老年人上消化道出血的临床特点。方法:回顾性总结183例非食管静脉曲张性上消化道出血患者住院病历,其中老年组82例,非老年组97例。详细记录临床,内镜检查结果。结果:老年组与非老年组上消化道出血的首要原因均为消化性溃疡,但老年组胃溃疡患病率(21.95%)明显高于非老年组(9.28%),差异有统计学意义P<0.05);老年组应用非甾体类抗炎药(NSAID s)明显增多,达30.48%,非老年组仅为4.12%,差异有统计学意义(P<0.05);与非老年组比较,老年组平均止血时间明显延长,分别为5.2d和3.5d。老年组治愈率为87.80%,非老年组为97.94%,差异有统计学意义(P<0.01)。结论:老年人上消化道出血临床病情较非老年人重,病程延长,治疗更为复杂。急诊的内镜检查与内镜下止血治疗是安全有效的措施。

Objective To investigate the characteristics of clinical course and outcome in elderly patients with acute nonvariceal upper gastrointestinal bleeding （ANUGIB）. Method The 183 hospitalized patients were devided into elderly group （ ≥60 years,82 cases） and non - elderly group （ 〈 60 years, 97 cases）. All patients were diagnosed acute nonvariceal upper gastrointestinal bleeding by endoscopy. Results Endoscopic findings included the first common cause to ANUGIB was peptic ulcer,whereas more gastric ulcer were seen in elderly patients than in non - elderly patients （ 21.95% vs 9.28 % , P 〈 0. 05 ）. More elderly patients had a history of using NSAIDs （30. 48% vs 4. 12 % ,P 〈 0.05 ）. Duration to bleeding stop was significantly longer in elderly group. The recovery rate was 87.80% in elderly group ,the others was 97.94% （P 〈 0. 05 ）. Conclusion The elderly patients have a more complicated clinical course than those non - elderly patients regarding to the need for intensive care, transfusion requirements, duration between bleeding stop and rebleeding. Emergency endoscopy is a safe and effective method for both diagnosis and treatment.