安阳地区上消化道出血病因及相关因素变化  

Changes of etiologic and related factors of upper gastrointestinal bleeding in Anyang region

作　　者：石国梁[1] 李闯[2] 

机构地区：[1]安阳地区医院消化内科,河南安阳455000 [2]新乡医学院第三附属医院检验科,河南新乡453003

出　　处：《新乡医学院学报》2013年第6期479-482,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨近20 a来安阳地区上消化道出血(UGIB)的病因及相关因素。方法回顾性分析1992年7月至2012年6月安阳地区医院确诊的UGIB患者共1 949例,按入院时间顺序及年龄分组,对比UGIB病因及其相关因素的变化。结果 UGIB患者中男性多于女性,性别比为73.7∶26.3,前10 a与后10 a性别构成比比较差异无统计学意义(P>0.05)。后10 a与前10 a比较,老年组UGIB发病率升高,而消化性溃疡出血仍是UGIB患者最主要的病因;食管胃底静脉曲张出血(EVB)发病率呈下降趋势;贲门黏膜撕裂综合征、食管炎并发出血呈升高趋势;对老年患者,急性胃黏膜病变(AGML)也是引起UGIB的重要原因,而胃癌、食管癌引起的出血发病率则变化不明显。结论近20 a来安阳地区UGIB的主要消化道疾病谱已发生变化,EVB发病率下降;中青年及老年患者消化道疾病谱亦有所差别,AGML对老年患者的危险性高于中青年患者。Objective To explore the changes of etiology and related factors of upper gastrointestinal bleeding（UGIB） in the last 20 years in Anyang region. Methods A total of 1 949 UGIB cases diagnosed in Anyang Area Hospital from Jul. 1992 to Jun. 2012 were analyzed retrospectively. Groups were divided according to admission chronological order and age. The changes of etiology and related factors of UGIB were analyzed. Results UGIB occurred more in men than in women, the gen- der ratio was 73.7 ： 26.3, there was no significant change in gender composition between the first and later 10 years （ P 〉 0. 05 ）. Compared the later 10 years with the first 10 years, the mobility of UGIB in elder patients group increased,while peptic ulcer bleeding was still the main cause of UGIB ;the occurrence rate of esophagogastric variceal bleeding（ EVB ）was in downward trend;mallory-weiss syndrome and esophagitis was in upward trend ;while in elder patients group（ age/〉60 years ） , acute gastric mueosal lession（AGML） was one of the important cause of UGIB,but changes of UGIB rate caused by gastric cancer and esophageal carcinoma weren＇t obvious. Conclusion The spectrum of disease of UGIB has changed in recent 20 years, the occurrence rate of EVB decreases, and there is distinction between young and middle-age patients and elder patients, the risk of AGML in elder patients is higher than that in young and middle-age patients.

关 键 词：上消化道出血 病因变化 消化性溃疡 胃底食管静脉曲张 急性胃黏膜病变 

分 类 号：R573.2[医药卫生—消化系统]