胃肠道溃疡出血患者住院期间死亡的单因素及Logistic多因素分析

Single Factor and Logistic Multi Factor Analysis of Death During Hospitalization in Patients withGastrointestinal Ulcer Bleeding

目的:分析影响胃肠道溃疡出血住院患者的相关死亡因素。方法:选取2013年1月-2015年6月本院收治的262例胃肠道溃疡出血患者作为研究对象,根据治疗结果分为生存组220例和死亡组42例,回顾性分析患者的一般资料、胃镜及实验室检查结果,采用单因素及Logistic多因素对其死亡危险因素进行分析。结果:两组在年龄、酗酒、凝血功能异常、服用非甾体类抗炎药(NSAID)、止血方式、再出血、合并症、休克、血红蛋白(Hb)、血小板(PLT)、白蛋白(ALB)、血尿氮(BUN)、前列腺素E2(PGE2)、血栓素A2(TXA2)、溃疡直径、幽门螺杆菌(H.pylori)感染及Forrest分级方面比较差异均有统计学意义(P<0.05);Logistic多因素分析显示,年龄≥60岁、服用NSAID、再出血、Forrest分级<Ⅱb及H.pylori感染为影响胃肠道溃疡出血的独立危险因素,血红蛋白和PGE2则为胃肠道溃疡出血死亡的保护因素。结论:密切关注和干预危险因素,改善相关的保护因素,对提高溃疡出血治疗和降低死亡率具有重要意义。

Objective：To Analysis the related death factors in hospitalized patients with gastrointestinal ulcer bleeding.Method：From January 2013 to June 2015,262 cases of gastric ulcer bleeding in our hospital were selected as the research objects,they were divided into the survival group of 220 cases and death group of 42 cases according to the results of the treatment,retrospective analysis of general information,gastroscopy and laboratory results for patients,the risk factors of death were analyzed by single factor and logistic multi factor analysis.Result：Two groups in age,drinking,coagulation abnormalities,took nonsteroidal body anti-inflammatory drugs（NSAID）,ways to stop bleeding,rebleeding,complication,shock,hemoglobin（Hb）,platelet（PLT）,albumin（ALB）,blood urea nitrogen（BUN）,prostaglandin E2（PGE2）,thromboxane A2（TXA2）,the diameter of ulcer,Helicobacter pylori（H.pylori） infection and Forrest graded difference had statistical significance（P0.05）.Logistic multivariate regression analysis showed that age,took an NSAID,rebleeding,forrest classificationⅡb and H.pylori infection for the independent risk factors of gastrointestinal ulcer bleeding,hemoglobin and PGE2 were the protective factors for the death of gastrointestinal ulcer bleeding.Conclusion：Pay close attention and interven on risk factors,improve the related protective factors are sigificant for improving treatment efficiency and reducing death rate in curing gastrointestinal uncler bleeding.