上消化道出血530例临床特征分析

A review of 530 upper gastrointestinal bleeding cases

目的探讨上消化道出血的临床特征和发病特点。方法回顾性分析530例上消化道出血患者,按年龄的不同将其分为非老年组和老年组,分别对住院天数、病因、合并慢性疾病、入院时化验指标和死亡情况等特点进行比较分析。结果非老年组患者住院天数显著少于老年组患者的住院天数(P<0.001)。非老年组患者出血原因主要包括十二指肠溃疡、急性糜烂出血性胃病、食管胃底静脉曲张破裂等,而老年组患者出血原因主要包括急性糜烂出血性胃病、食管胃底静脉曲张破裂、胃溃疡等。非老年组消化性溃疡发生率(42.41%)显著高于老年组(16.25%),而非老年组胃癌的发病率明显小于老年组(P<0.001,P<0.05)。两组死亡病例中均以食管胃底静脉曲张破裂出血及合并慢性疾病的病例居多。结论上消化道出血的常见病因包括消化性溃疡、急性糜烂出血性胃病、食管胃底静脉曲张破裂出血和胃癌,消化性溃疡多见于非老年组。食管胃底静脉曲张破裂出血仍是导致患者死亡的主要原因。

Objective To review the clinical characteristics in patients with upper gastrointestinal bleeding （UGB）. Methods 530 cases of UGB inpatients were retrospectively analyzed and divide into non-elderly group and elderly group. The analytical data involved hospitalization day, the reasons for hospitalization, combination with chronic diseases, biochemical examination during admission and even death information. Results The non-elderly group stayed in hospital shorter than the elderly group （ P 〈 0.00l ）. The main causes of UGB in the non-elderly group were duodenal ulcer（DU）, acute hemorrhagic gastropathy and varices bleeding etc while those in the elderly group were acute hemorrhagic gastropathy, varices bleeding and gastric ulcer（GU） etc. The detecting rate of peptic ulcer（PU） in the non-elderly group （42.41%） was significantly higher than that in the eldly group（16.25% ）. Gastric cancer was more common in the eldly group than that in the non-elderly group（P 〈0.001 ,P 〈0.05）. Varices bleeding with or without chronic disease were the main causes for death. Conclusion The main reasons of UGB are PU, acute hemorrhagic gastropathy, varices bleeding, gastric cancer. PU is more common in the non-elderly groups. Varices bleeding is the main cause of death in UGB patients.