老年人贫血消化道内镜检查分析

Digestive tract endoscopy for examination the aged man with anemia

目的 探讨老年性贫血患者在消化内镜检查的病因分布及与贫血程度、临床症状的关系。方法 回顾性分析近4年来采用电子胃镜、肠镜对年龄≥ 60岁 ,血红蛋白 (Hb)男 <12 0 g/L ,女 <110g/L ,临床考虑胃肠道慢性隐性失血患者的检查结果 ,结合其贫血程度、临床类型进行比较分析。结果 老年贫血患者在胃镜检查中常见的疾病依次为糜烂性胃炎 ,十二指肠球部溃疡和胃癌 ;肠镜检查则以直、结肠癌及慢性结肠炎多见。临床表现以腹痛、腹胀、恶心、呕吐多见。恶性肿瘤总检出率为 2 9.14 % ;双向检查均检出致贫血病变的占 8.2 9% ;恶性肿瘤以重度贫血为主 ,其它疾病则以轻、中度贫血多见 ;总HP感染率为 67.19%。结论 消化道慢性隐性失血所致的老年性贫血 ,消化道症状常不典型 ,结合所具有的消化道症状应及早行相应内镜检查 。

Objective To assess the relationship between disease cause distribution and degrees of anemia and clinical symptoms in the aged patients with anemia under digestive tract endoscopy. Methods The examination results and their correlation to anemia degrees and clinical classification were retrospectively analyzed in patients who received gastrofiberscopy and enteroscopy examination, above the age of 60 years old, with Hb ( male<120g/L, female<110g/L ), and preliminarilly clinically diagnosed as chronic concealed hemorrhage in recent four years. Results Under gastrofiberscopy examination, the most common disease in the aged men with anemia were erosive gastritis, duodenal bulbar ulcer and carcinoma of stomach; and under enteroscopy, the common diseases were rectum, colon carcinoma and chronic colitis. The common clinical symptoms were abdominal pain, abdominal distension and nausea. The detectable rate of malignant tumor was 29.14%; and 8.29% of the lesions resulted in anemia were found out by double examination. Malignant tumor mainly resulted in severe anemia, other diseases mainly caused light, mild anemia. The detectable rate of HP was 67.19%. Conclusions The digestive tract symptoms is usually not typical in the aged men with anamia induced by chronic concealed hemorrhage in digestive tract. Once the digestive tract symptoms occurred, corresponding endoscopy should be given to the patients early and it is better for patients with anemia without typical symptoms to receive double endoscopy.