老年人急性非静脉曲张性上消化道出血病因及相关因素分析

The pathogeny and relative factors analysis of acute non-variceal upper gastrointestinal hemorrhage in aged people

目的:探讨老年人急性非静脉曲张性上消化道出血病因及相关因素。方法:对104例经胃镜确诊的老年人急性非静脉曲张性上消化道出血患者(观察组)的临床资料进行回顾性分析,并将104例经胃镜确诊的中青年急性非静脉曲张性上消化道出血患者设为对照组。比较2组患者的病因、失血性周围循环衰竭发生率、住院时间、诱因、合并症、再出血率(住院期间再出血发生率)及病死率。结果:2组患者的病因以消化性溃疡为主,病因构成差异无统计学意义(P>0.05)。观察组主要诱因为幽门螺杆菌感染及非甾体抗炎药应用,而对照组以幽门螺杆菌感染及饮酒为主。观察组失血性周围循环衰竭发生率、合并症、住院时间、再出血率、病死率均较对照组高(P<0.05～P<0.01)。结论:老年人急性非静脉曲张性上消化道出血一旦发生,应尽早明确病因及诱因,合理治疗可降低病死及再出血率。

Objective ：To investigate the pathogeny and relative factors of acute non-variceal upper gastrointestinal hemorrhage in aged people. Methods： The clinical data of 104 aged people with acute nonvariceal upper gastrointestinal hemorrhage diagnosed by gastroscope （observation group） were retrospectively analyzed, 104 young and middle-aged people with acute nonvarieeal upper gastrointestinal hemorrhage diagnosed by gastroseope were set as control group. The causes of disease, uncontrolled hemorrhagic incidence of peripheral circulatory failure, stay days, incentive, complications, the rebleeding rate（ during hospital stay） and mortality of two groups were analyzed. Results： The peptic ulcer was the main causes of disease in two groups, their causes composition was not statistical significance（ P 〉 0.05 ）. Helicobacter pylori （Hp） infection and the application of non-steroidal anti-inflammatory drug were the main incentive in observation group, Hp infection and drinking were the main incentive in control group. Uncontrolled hemorrhagic incidence of peripheral circulatory failure, stay days, complications, the rebleeding rate and mortality of observtion group were higher than those in control group（ P 〈 0.05 to P 〈 0.01 ）. Conclusions： Clearing pathogeny and inducement as early as possible and taking reasonable treatment during the period of acute non-variceal upper gastrointestinal hemorrhage can reduce the mortality and rebleeding rate of aged people. Strengthening health education can reduce the incidence of upper gastrointestinal hemorrhage.