消化道出血病因的临床分析

Clinical Analysis of Gastrointestinal Bleeding

目的:回顾性分析消化道出血的病因构成、相关因素及治疗情况。方法:收集2008年7月至2013年9月因消化道出血在沈阳军区总医院消化内科住院的患者资料,包括患者的一般资料、入院日期、病因、出血部位、生命体征、疾病史。依据消化道出血程度分为轻度组(86例)、中度组(90例)、重度组(132例),分析消化道出血的病因特征。结果:与轻度组比较,重度组上消化道出血患者比例较高,中、重度组Blatchford评分、心率、尿素、血肌酐、凝血酶原时间、INR、血糖明显升高(P<0.05);收缩压、舒张压、红细胞、血红蛋白、总蛋白、白蛋白、总胆固醇明显减低(P<0.05)。重度组患有食管胃底静脉曲张的比例较高,行内镜下治疗的比例高(P<0.05)。结论:根据患者出血程度可初步判断患者消化道出血的部位及病因,为临床诊治提供有价值的参考依据。

Objective： To explore the specturm and frequency causes, correlative factors and therapy of gastrointestinal bleeding. Methods： The medical records of three hundred and eight cases of gastrointestinal bleeding patients admitted in our hospital from July 2008 to September 2013 were collected, including clinical conditions, admittion time, causes, bleeding points, vital signs, and medical his- tory. According to the bleeding degree, they were divided into three groups （mild, moderate and severe）. The feature of gastrointestinal bleeding causes was analyzed. Results： The incidence rate of upper gastrointestinal bleeding was significantly higher in severe group than that of mild group. The Blatchford scoring system, heart rate, blood urea nitrogen, creatinine, prothrombin time, INR for prothrombin time, and blood glucose level were significantly higher in severe group and moderate group than those in mild group （P〈0.05）, while the sys- tolic blood pressure, diatolic blood pressure, red blood cell, hemoglobin, total protein, albumin, and total cholesterol, were significantly lower in severe group and moderate group than those in mild group（P〈0.05）. The percentage of esophageal-gastric variees and endoscop- ic treament were significantly higher in severe group （P〈0.05）. Conclusion： The position and causes of gastrointestinal bleeding could be evaluated according to the blooding degree, which would provide references for the diagnose and treament of gastrointestinal bleeding.