135例非老年急性上消化道出血患者的病因分析

Analysis of the Etiology of 135 Cases with Acute Upper Gastrointestinal Bleeding in Non Elderly Patients

目的：分析探讨非老年患者上消化道出血的原因及相关因素。方法对我院2009年~2012年间收治的135例非老年上消化道出血患者的临床资料进行回顾性分析，并与同期住院86例老年患者的出血原因进行比较。结果在135例非老年上消化道出血病例中，饮酒、精神因素、不当饮食为主要相关诱发因素，老年组中以服用非甾体药物为主要诱因。而非老年组中最常见的出血病因为十二指肠溃疡占34.81%（47/135），第二位是食管胃底静脉曲张破裂占18.52%（25/135），其他常见的病因还有急性胃黏膜病变15.56%（21/135），胃溃疡11.58%（16/135），消化道肿瘤7.41%（10/135）等。其中十二指肠溃疡、食管胃底静脉曲张发病率明显高于老年组，而胃溃疡、消化道肿瘤发病率低于老年组患者（P＜0.05）。结论与老年组有所不同，非老年上消化道出血诱因多与饮酒、精神因素、不当饮食有关，十二指肠溃疡、食管胃底黏膜曲张破裂是致出血的主要病因，且发病率男性多于女性。

Objective To investigate the cause of upper gastrointestinal bleeding and relevant factors in non elderly patients. Methods Clinical data of 135 non elderly patients with upper gastrointestinal bleeding during 2009 and 2012 in our hospital and 86 cases of elderly patients at the same period were retrospectively analyzed. The causes of acute gastrointestinal bleeding were compared. Results Drinking wines, mental factors and improper diets in non elderly patients were main inducements leading to gastrointestinal hemorrhage. The inducement of the elderly group was NSAID drug. The most common cause of gastrointestinal hemorrhage in the non elderly group was the duodenal ulcer accounted for 34.81%（47/135）, the second was the esophageal gastric fundus varicosity burst accounted for 18.82%（25/135）. Other causes were acute gastric mucosal lesion 15.56%（21/135）, gastric ulcer 11.58%（16/135） and the digestive tract cancer 7.41%（10/135） etc. The incidence of the duodenal ulcer and the esophageal gastric fundus varicosity burst were significantly higher than the elderly group, the incidence of gastric ulcer and the digestive tract cancer in turn were significantly lower than the elderly group （P＆lt;0.05）. Conclusion Compared with the elderly group, the inducements of the non elderly group were related to drinking wines, mental factors and improper diets. The duodenal ulcer and the esophageal gastric fundus varicosity burst were accounted for main two causes of acute upper gastrointestinal bleeding and the ratio is higher in males than in females.