3042例上消化道出血患者病因分析及护理对策

Etiology of gastrointestinal bleeding in elderly patients and nursing strategies

目的探讨3042例上消化道出血患者的病因,并提出护理对策。方法回顾性分析本院1991年3月～2009年3月3042例上消化道出血住院患者的病因,并提出对策。结果消化性溃疡出血为上消化道出血的主要病因,占46.96%,其中十二指肠溃疡呈下降趋势;急性胃黏膜病变为上消化道出血的第2病因,占28.76%,呈上升趋势;年龄<60岁组患者十二指肠溃疡是上消化道出血的主要病因(占44.35%),年龄≥60岁组患者急性胃黏膜病变为上消化道出血的主要病因(41.21%)。结论消化性溃疡出血与急性胃黏膜病是上消化道出血的主要病因,其中十二指肠溃疡呈下降趋势,其也是年龄<60岁组患者的主要病因;急性胃黏膜病变呈上升趋势,其也是年龄≥60岁患者的主要病因。在护理工作中,应针对不同年龄患者病因与疾病谱变化情况,开展针对性的健康教育,促进患者行为改变,从而达到防病、治病的目的。

Objective To explore the etiology of gastrointestinal bleeding in elderly patients and propose nursing strategies gastrointestinal bleeding. Method The histories of 3 042 inpatients with upper gastrointestinal bleeding in our hospital between March 1991 to March 2009 were retrospectively analyzed for detection of the etiological factors. Results The main etiological factors included peptic ulcer bleeding （46.96%） and acute gastric mucosal lesion （28.76%） gastrointestinal bleeding; duodenal ulcer （44.35%） in those aged less than 60 years group and the acute gastric mucosal lesion （41.21%） in those aged more than 60 years. Conclusions Acute gastric mucosal lesion and peptic ulcer bleeding are major etiological factors for upper gastrointestinal bleeding in elderly patients. In our nursing work, health education should be done according to the etiological factors and the disease spectrum change to reduce the incidence and mortality from upper gastrointestinal bleeding.