阿司匹林致老年患者上消化道出血的特征

Elderly Patients Taking Aspirin Induced Gastrointestinal Bleeding Characteristics

目的研究与分析服用阿司匹林导致老年患者上消化道出血的临床特征。方法将2011年1月至2014年12月消化内科收治的上消化道出血患者96例,根据患者出血前是否服用阿匹林分为观察组和对照组各48例。观察组服用阿司匹林,对照组未服用阿司匹林。分析观察组组内服用阿司匹林的剂量、时间长短;分析观察组、对照组两组患者的年龄、性别、严重消化道出血、出血方式、出血部位、内镜下特征及幽门螺旋杆菌(Hp)阳性率的差别。结果观察组组内比较服用阿司匹林剂量(75 mg和100 mg)差异无统计学意义(P>0.05);观察组与对照组性别差异、消化道出血方式、内镜下特征差异无统计学意义(P>0.05);观察组组内服用阿司匹林平均时间长的患者发生上消化道出血率更高,差异有统计学意义(P<0.05);观察组年龄大于对照组;观察组严重消化道出血发生率高于对照组;观察组以胃底体溃疡多见,对照组以胃窦溃疡多见;观察组幽门螺杆菌(Hp)感染的阳性率高于对照组,差异均有统计学意义(P<0.05)。结论高龄患者服用阿司匹林更易导致消化道出血,服用阿司匹林时间长的老年患者发生上消化道出血率更高,且出血程度较重,出血部位好发于胃体、胃底部,幽门螺旋杆菌(Hp)感染的阳性率更高,因此,临床医师应综合患者一般状况结合胃镜诊断,并全面考虑患者基础疾病,实施针对性干预。

Objective To study and analyze the clinical characteristics of aspirin cause gastrointestinal bleeding in elderly patients. Methods On January 2011-2014 December Gastroenterology treated 96 patients with gastrointestinal bleeding, according to whether taking aspirin Arab divided into observation group and con- trol group patients before bleeding all 48 cases. Observation group taking aspirin control group not taking aspirin. Analysis groups were age, sex, aspirin dose, duration, severe gastrointestinal bleeding, bleeding difference meth- ods, the bleeding site, endoscopic features and Helicohacter pylori （Hp） positive rate. results observed gender dif- ferences with the control group, aspirin dose （75 mg and 100 mg） differences in the way gastrointestinal bleed- ing, endoscopic characteristics showed no significant difference（P 〉 0.05）;observe age group than the control group; observation group taking aspirin average time than the control group leader;observation group was higher incidence of severe gastrointestinal bleeding; observation group with gastric ulcer common body, the control group antral ulcer common; observation group Helicohacter pylori （Hp） infection positive rates higher, the dif- ference was statistically significant（P 〈 0.05）. Conclusion Elderly patients more likely to cause gastrointestinal bleeding aspirin, aspirin long time higher in elderly patients with upper gastrointestinal bleeding rate and extent of heavy bleeding, bleeding sites occur in the gastric body, the bottom of the stomach, Helicohacter pylori（Hp） higher positive rate of infection, therefore, clinicians should combine the general condition of the patient integrat- ed endoscopic diagnosis and comprehensive consideration of the patient＇ s underlying disease, the implementation of targeted interventions.