老年人上消化道出血临床特征分析

Clinical features of upper gastro-intestinal hemorrhage in aged patients

目的分析老年人上消化道出血临床特征，为临床及时合理的治疗提供依据。方法回顾性分析确诊的上消化道出血病例201例，其中老年组患者100例，非老年组患者101例的临床资料。结果老年组以消化性溃疡为首要病因（39．00％），但胃溃疡出血发生率（24．00％）高于十二指肠溃疡发生率（15．00％）；而非老年组以十二指肠溃疡为主。老年组合并疾病多（70．00％），显著高于非老年组（24．75％），2组比较差异有统计学意义（X^2=41．27，P〈0．01）。老年组临床表现以呕血多见（28．00％），相比非老年组（7．92％）差异有统计学意义（X^2=13．78，P〈0．01）。老年组多接受非甾体抗炎药（NSAIDs）或抗凝剂治疗合并疾病。结论老年人上消化道出血的首要病因是消化性溃疡并出血，其中胃溃疡出血发生率较高，多有呕血表现，且合并疾病明显增多。老年人宜选择应用质子泵抑制剂。

Objective To study the clinical features of upper gastro-intestinal hemorrhage in aged patients and provide information for timely and reasonable treatment for these patients. Methods The clinical data of 100 aged patients with upper gastro-intestinal hemorrhage （ group A） were analyzed retrospectively. As control, 101 cases of non-aged patients with the same condition were selected for comparison （Group B）. Results The main cause of upper gastro-intestinal hemorrhage in aged patients was peptic ulcer（39% ） ,but the rate of hemorrhagein gastric ulcer（24. 00% ）was higher than that of duodenal ulcer （ 15.00% ）. However, in the non- aged patients, duodenal ulcer caused higher chance of upper gastro-intestinal hemorrhage than gastric ulcer. Aged group has higher complications （ 70. 00% ）, which was significantly higher than that in non-aged group （24.75%） （X^2 =41.27, P 〈 0.01 ）. Haematemesis occurred more frequently in aged group （ 28. 00% ） thanthat of 7.92% in the non-aged group（X^2 = 13.78 ,P 〈 0.01 ）. Most patients in aged group received NSAIDs and anticoagulant to treat complications. Conclusion The primary cause of ttpper gastro-intestinal haemorrhage in aged patients was peptic ulcer, with relatively high incidence in gastric ulcer patients, and frequent incidence of haematemesis and complications. Aged patients were recommended to receive PPI therapy.