老年急性上消化道出血临床特征观察  

Observe clinical characteristics of elderly with acute upper gastrointestinal bleeding

作　　者：邱伟伟[1] 陈建荣[1] 

机构地区：[1]南通大学附属医院分院消化内科,江苏南通226001

出　　处：《中国处方药》2016年第6期12-13,共2页Journal of China Prescription Drug

摘　　要：目的探讨老年急性上消化道出血特点及处理方法。方法回顾性分析2012年1月~2015年6月南通大学附属医院分院诊治的60例老年急性上消化道出血患者的临床资料。结果出血前有上腹疼痛及不适42例,无消化系统症状18例;出血前有服用非甾体抗炎药15例;合并心、脑、肾、肝等疾病38例。急性上消化道出血表现为黑便23例,呕血17例,呕血及黑便10例,体检或其他检查时发现10例。出血症状包括有乏力、面色苍白、头晕等52例,出血休克8例。病程中伴发病12例。出血原因为胃溃疡20例,急性胃黏膜病变15例,胃癌及食管癌10例,十二指肠球部溃疡10例,食管胃底静脉曲张破裂及其他5例;治疗出血停止平均（9.23±4.34）d,死亡4例。结论老年急性上消化道出血临床表现不典型,出血原因复杂,并发症多,预后较差,应及时给予有效治疗,同时注意保护全身的重要器官功能。Objective To explore the characteristics of elderly with acute upper gastrointestinal bleeding and treatment methods. Methods A retrospective analysis of 60 cases of elderly patients with acute upper gastrointestinal bleeding were made. The patients were diagnosised and treated in branch hospital of nantong university affiliated hospital from January 2012 to June 2015. Results 42 cases of patients were with epigastric pain and discomfort before bleeding,and 18 cases were without symptoms of digestive system; Before bleeding, 15 cases had taken non-steroidal anti-inflammatory drugs like aspirin; 38 cases were appear to Merge diseases such as heart, brain, kidney. 23 cases of acute upper gastrointestinal bleeding patients were melena, 17 cases hematemesis, 10 cases hematemesis and melena, 10 cases found during a medical or other inspection. 52 cases showed bleeding symptoms include fatigue, pale complexion,dizziness and other, 8 cases of hemorrhage shock. In the course, 12 cases were with onset. Cause of bleeding was 20 cases of gastric ulcer, acute gastric mucosal lesions in 15 cases, 10 cases of gastric cancer and esophageal cancer, 10 cases of duodenal bulb ulcers, stomach esophagus varicosity burst and other 5 cases; Treatment of bleeding stopped（9.23±4.34） days on average, 4 cases died. Conclusion Clinical manifestation of Elderly patients with acute upper gastrointestinal bleeding is not typical with complex bleeding reason, much complications and poorer prognosis. The patients should be given timely effective treatment, and maintain vital organ function of the body at the same time.

关 键 词：老年 急性上消化道出血 临床特征 

分 类 号：R573.2[医药卫生—消化系统]