急性上消化道出血患者的临床特征及不良预后的影响因素

Clinical Characteristics of Patients with Acute Upper Gastrointestinal Hemorrhage and the Influencing Factors of Poor Prognosis

目的 观察急性上消化道出血患者的临床特征,探讨影响其预后的影响因素。方法 回顾性分析2019年10月至2021年10月虞城县人民医院收治的240例急性上消化道出血患者的临床资料,根据患者预后分为预后不良组(31例)和预后良好组(209例)。记录患者的临床特征,并分析其预后的影响因素。结果 临床症状表现方面,急性上消化道出血患者呕血50例(38.46%)、黑粪症63例(26.25%)、便血57例(23.75%)、粪便隐血阳性40例(16.67%)。既往用药情况,抗凝剂133例(55.42%)、抗血小板药物61例(25.42%)、非阿司匹林非甾体抗炎药46例(19.17%)。预后不良组患者输注新鲜冰冻血浆、肝硬化及胃肠道肿瘤占比与预后良好组比较,差异有统计学意义(P<0.05);后经logistic回归分析结果显示,输注新鲜冰冻血浆、肝硬化、胃肠道肿瘤是急性上消化道出血预后不良的相关因素(OR>1,P<0.05)。结论 急性上消化道出血患者临床表现以呕血、黑粪症较为常见,抗凝剂、抗血小板药物的使用占比较高,且输注新鲜冰冻血浆、肝硬化、胃肠道肿瘤是急性上消化道出血预后不良的相关因素。

Objective To observe the clinical characteristics of patients with acute upper gastrointestinal hemorrhage and explore the related factors affecting their prognosis.Methods The clinical data of 240 patients with acute upper gastrointestinal hemorrhage admitted to Yucheng People’s Hospital from October 2019 to October 2021 were retrospectively analyzed.According to the prognosis,the patients were divided into poor prognosis group(31 cases) and good prognosis group(209 cases).The clinical characteristics of the patients were recorded,and the related influencing factors of their prognosis were analyzed.Results In the aspect of clinical symptoms,50 cases(38.46%) of acute upper gastrointestinal hemorrhage had hematemesis,63 cases(26.25%) of black stool,57 cases(23.75%) of hematochezia,and 40 cases(16.67%) of fecal occult blood.Anticoagulants in 133 cases(55.42%),anti-platelet drugs in 61 cases(25.42%),non aspirin and non steroidal anti-inflammatory drugs in 46 cases(19.17%).The proportion of fresh frozen plasma infusion,liver cirrhosis and gastrointestinal tumor in the poor prognosis group was higher than that in the good prognosis group(P1,P<0.05).Conclusion The clinical manifestations of patients with acute upper gastrointestinal hemorrhage are hematemesis and meconium.The proportion of anticoagulants and anti-platelet drugs is high,and the infusion of fresh frozen plasma,liver cirrhosis and gastrointestinal tumors are the relevant factors for the poor prognosis of acute upper gastrointestinal bleeding.