老年急性上消化道出血患者临床特点分析

Clinical features of aged patients with acute upper gastrointestinal hemorrhage

目的总结和分析老年急性上消化道出血患者临床特点。方法回顾性分析2008年1月至2013年12月于同济医院住院治疗的老年上消化道出血患者289例和非老年上消化道出血患者301例,比较两组患者上消化道出血临床表现、出血原因、并发症以及预后情况。结果老年组上消化道出血仍以消化性溃疡常见,胃溃疡出血为主,与非老年组以十二指肠溃疡出血为主相比,两组差异有统计学意义(P<0.05);老年组因胃癌、非甾体类药物所致出血明显多于非老年组,两组比较差异有统计学意义(P<0.05);老年组腹痛发病率显著低于非老年组(P<0.01);老年组伴发病和病死率均高于非老年组,两组比较差异均有统计学意义(P<0.01)。结论老年组上消化道出血以消化性溃疡为多见,胃癌、非甾体类抗炎药物所致出血较多,伴发病和病死率高,掌握其临床特点,及早发现并干预,对于阻止病情进展、降低病死率有显著意义。

Objective To review the clinical features of upper gastrointestinal hemorrhage in aged patients. Methods Clinical data of 289 elderly patients and 301 non-elderly patients with upper gastrointestinal hemorrhage admitted in Tongji hospital from January 2008 to December 2013 were retrospectively analyzed. The clinical features, the causes of hemorrhage, the complications and the prognosis were compared between two groups. Results The morbidity rate of gastric ulcer in elderly group was significantly higher and the morbidity rate of duodenal ulcer was significantly lower than those in non-elderly group （P 〈 0. 05 ）. The hemorrhage rate induced by gastric cancer and non-steroid anti-inflammatory drugs （NSAIDS） in elderly group was significantly higher than that in non-elderly group （P 〈 0. 05 ）. The incidence rate of abdominal pain in elderly group was significantly lower than that in non-elderly group （P 〈0. 01）. The complications and mortality in elderly group were significantly higher than that in non-elderly group （P 〈 0. 01 ）. Condusion To understand the clinical features of upper gastrointestinal hemorrhage in elderly patients would be helpful for early intervention and prevention of the disease progression.