老年上消化道出血146例临床及内镜分析

Clinical and endoscopic analysis on 146 cases of elderly upper digestive tract bleeding

目的对老年上消化道出血患者的病因、临床症状及内镜检查结果进行分析。方法以2010年3月至2011年3月收治的146例上消化道出血患者为研究对象,对其临床资料进行回顾性分析,将患者按年龄分为老年组(73例)和中青年组(73例),对两组研究对象的病因、临床症状及内镜检查结果进行对比分析。结果根据患者的临床症状及胃镜检查结果,老年组十二指肠溃疡14例,胃溃疡24例,复合性溃疡6例,食管胃底静脉曲张破裂出血9例,急性胃黏膜病变7例,胃癌13例。因胃溃疡、复合性溃疡、肿瘤引发出血的患者数老年组高于中青年组,差异有统计学意义(P<0.05);因十二指肠溃疡导致出血的患者数老年组明显低于中青年组,差异也有统计学意义(P<0.05)。结论导致老年上消化道出血的原因为消化性溃疡、食管胃底静脉曲张破裂、胃癌、急性胃黏膜病变等,与中青年患者的发病原因有显著区别。

Objective To analyze the etiology ,clinical symptoms and endoscopic findings of elderly upper gastrointestinal bleeding . Methods 146 cases of upper upper digestive tract bleeding treated in this hospital from March 2010 to March 2011 were selected as the study subjects and their clinical data were retrospectively analyzed. The patients were divided into the elderly group and the young and middle-aged group by age, 73 cases in each group. The etiology, clinical symptoms and endoscopic findings were comparatively analyzed. Results According to the clinical symptoms and the gastroscopie findings, the elderly group had 14 cases of duodenal ulcer, 24 cases of gastric ulcer,6 cases of compound ulcer,9 cases of esophageal and gastric varices bleeding, 7 cases of acute gastric mucosal lesion and 13 cases of gastric cancer. The cases of hemorrhage induced by gastric ulcer, compound ulcer and tumor in tile eldderly group were higher than those in the young and middle-aged group with statistical difference （P〈0.05）. The cases of hemorrhage induced by duodenal ulcer in the elderly group were significantly lower than those in the young and middle-aged group, difference between the two groups showing statistical significance （P〈0.05）. Conclusion Elderly upper gastrointestinal bleeding are mainly caused by peptic ulcer, esophageal and gastric varices rupture, gastric cancer and acute gastric mucosal lesions, which are significantly different from those in the young and middle-aged patients.