不同群组上消化道出血相关危险因素及危险度评估

目的了解急诊医学科上消化道出血(upper gastrointestinal bleeding,UGB)的相关危险因素及进行评估危险度。方法进行回顾性研究,分析140例上消化道出血患者的临床资料,按年龄分为青、中、老3组。采用Blatchford评分系统对患者行危险度分级。结果 3组上消化道出血首位病因均是消化性溃疡,青年组第2位和第3位病因是急性胃粘膜病变、食管胃底静脉曲张;中年组第2位和第3位病因是食管胃底静脉曲张、消化道肿瘤;老年组第2位和第3位病因是急性胃粘膜病变、消化道肿瘤。男多于女(比例2.8∶1)。饮食不当为青、中年组上消化道出血的首位诱因,服阿司匹林为老年组上消化道出血的首位诱因。老年人在中高危组占的比例高,达48.5%。结论不同群组上消化道出血有不同的临床特点,可能与性别、病因、诱因有关。根据上消化道出血的相关危险因素分析和Blatchford评分,提示临床诊治过程中更加注意老年人的上消化道出血。

Objective Conduct research on the department of emergency medicine within our hospital and related factors of upper gastrointestinal hemorrhage and risk assessment.Methods The hospital retrospectively analyzed the emergency medicine using the clinical data of one hundred and forty patients with upper gastrointestinal hemorrhage. These patients were divided intoyoung Patients, middle Age Patients and elderly Patients according to age.The Blatchford score line risk classification on the patients. Results The first cause identified of upper gastrointestinal hemorrhage within all three groups was peptic ulcer. The second and the third cause within the younger patients were acute gastric mucosal lesion and cirrhosis with esophageal gastric fundus varicosity burst. In the middle-aged group the causes were cirrhosis with esophageal gastric fundus varicosity burst and the digestive tract cancer. In the elderly group, the primary causes were acute gastric mucosal lesion and the digestive tract cancer.Men were diagnosed more often than woman, at a ratio of 2.8 ： 1. Improper dietary habits were the first cause of upper gastrointestinal hemorrhage for youth and the middle-aged group. Aspirin was identified as the primary cause of upper gastrointestinal hemorrhage for the elderly group. The proportion of the elderly in the high-risk group of was identified as being very high, up to 48.5%. Conclusion Different groups have different clinical characteristics, and findings show that upper gastrointestinal hemorrhage may be associated with sex, etiology and inducement. According to the investigation of the factors of upper gastrointestinal hemorrhage and the Blatchford score, it is important to give more attention to the elderly in the process of clinical diagnosis and treatment of upper gastrointestinal hemorrhage.