急性上消化道出血的病因及相关因素分析

Etilolgy and correlative factors of upper gastrointestinal bleeding

目的:探讨急性上消化道出血的病因与诱因。方法:选择2013-11-2016-11我科收治的急性上消化道出血患者共276例,依据患者资料分析病因、诱因等。结果:急性上消化道出现病因为消化性溃疡115例(41.7%),其中十二指肠溃疡60例(52.17%),胃食道静脉曲张破裂出血55例(19.9%),出血性胃炎22例(8%),应激性溃疡19例(6.9%),胃癌18例(6.5%),门脉高压性胃病5例(1.8%)。40~65岁患者占47.10%,65岁以上老年组占35.87%,40岁以下青年组占17.03%。男性居多,占65.58%,女性占34.42%。春季、冬季为高发季节。静脉曲张破裂出血及胃癌预后不佳。上消化道出血总病死率6.52%,年龄、恶性肿瘤病史、低血色素、呕血为死亡的危险因素。结论:急性上消化道出血常见病因有消化性溃疡、胃食道静脉曲张、出血性胃炎及胃癌,在不同年龄组病因分布具有差异性,静脉曲张破裂出血及胃癌造成的短期病死率高,年龄、恶性肿瘤病史、低血色素、呕血是患者死亡的重要风险因素。

Objective：To investigate the etiology and causes of acute upper gastrointestinal hemorrhage. Method： A total of 276 cases of patients with hemorrhage from November 2013 to November 2016 in our hospital for patients with acute upper digestive tract, were analyzed retrospectively. Result： The causes of acute upper digestive tract disease because of peptic ulcer in 115 cases （41.7 %） including 60 cases of duodenal ulcer （52.17 %） gastroesophageal variceal bleeding in 55 cases （19.9%） of 22 cases of hemorrhagic gastritis （8%） of 19 cases of stress ulcer （6.9%） gastric cancer in 18 cases （6.5%） of 5 cases of portal hypertensive gastropathy （1.80/oo） patients,40 465 years old accounted for the highest,reaching 47.10% ,above 65 years old group 35.87% ,40 under the age of 17.03% youth group. Male majority,65.58%,female accounted for 34.42%. Spring and winter are high season. The prognosis of variceal bleeding and gastric cancer is poor. The total mortality rate of 6. 52%% gastrointestinal bleeding,age,history of malignancy, low hemoglobin, hematemesis for the risk factors of death. Conclusion.. The common causes of acute upper gastrointestinal bleeding peptic ulcer,gastric variceal bleeding,gastritis and gastric cancer, the distribution among different age groups have different short-term mortality, variceal bleeding and gastric cancer caused by high, when age, malignant tumor history, low hemoglobin, hematemesis patients with poor prognosis.