老年上消化道出血病因、症状及其内镜检查结果分析  

Analysis on the causes and symptoms of upper gastrointestinal bleeding in the elderly and the results of endoscopic examination

作　　者：刘烈辉 李捷壮 邹伟廉 李斌 

机构地区：[1]广东省河源市人民医院消化内科,517000

出　　处：《齐齐哈尔医学院学报》2016年第13期1653-1655,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨老年上消化道出血病因、症状及其内镜检查结果。方法回顾性分析2012年3月至2015年6月我院消化内科收治的上消化道出血患者875例临床资料及内镜检查结果,按照年龄将875例患者分为老年组398例、中青年组477例,均给予内科保守治疗,比较分析两组患者上消化道出血发病病因、症状、发病诱因以及治疗预后。结果老年组上消化道出血病因主要为胃溃疡、十二指肠溃疡以及胃、食管癌等,中青年组上消化道出血病因主要为十二指肠溃疡、胃溃疡以及食管胃底静脉曲张,老年组患者胃溃疡发生率显著高于中青年组(P<0.05),而中青年组患者十二指肠溃疡以及食管胃底静脉曲张发生率显著高于老年组(P<0.05);老年组患者黑便为首发症状、上腹痛以及外周循环差发生率显著高于中青年组,差异具有统计学意义(P<0.05);老年组患者出血前有诱因患者254例、中青年组患者出血前有诱因患者234例,老年组服用非甾体类抗炎药、服用抗血小板药以及心脑肺肾疾病诱因显著高于中青年组(P<0.05),而中青年组饮食不当、饮酒以及精神紧张、劳累诱因显著高于老年组(P<0.05);治疗后老年组患者转急诊手术率以及死亡率均高于中青年组(P<0.05)。结论老年上消化道出血病因多为胃溃疡以及十二指肠溃疡,临床表现不典型,积极的内科治疗手段可获得较为良好的预后。Objective To investigate the causes, symptoms and results of endoscopic examination of upper gastrointestinal bleeding in elderly patients. Methods Retrospectively analyzed the clinical data and the results of endoscopy of 875 cases of patients who hospitalized in department of gastroenterology of our hospital during 2015 March 2012 and June 2006 because of upper gastrointestinal bleeding. According to the age, the 875 eases of patients were randomly divided into the elderly group （ n = 398 ） and young group （ n = 477 ）, all of them were given conseivative treatment. Comparison and analysis was clone on the pathogenesis and etiology, symptoms, risk factors and prognosis of two groups of patients with upper gastrointestinal hemorrhage. Results In elderly group the digestive tract hemorrhage mainly because of gastric ulcer, duodenal ulcer and gastric or esophageal carcinoma. In the youth group digestive tract hemorrhage mainly caused by duodenal ulcer, gastric ulcer and esophageal and gastric fundus variees. The incidence of gastric ulcer in the elderly group was significantly higher than that in young group （ P 〈 0.05 ）. In young patients the occurrence of duodenal ulcer and esophageal and ga,~tric fundus varices was significantly higher than that in elderly group （ P 〈 0. 05 ）. The incidence of me]ena was the first symptom in the elderly group, upper abdominal pain and peripheral circulation rate was significanlJy higher than that in the young group, and the difference was statistically significant （P 〈 0. 05 ）. 254 elderly patients with inducement before bleeding, 234 cases of young patients with inducement before the bleeding. Patients in the elderly group taking non steroidal anti - inflammatory, anti - platelet and cardiovascular and lung and kidney disease drugs were significantly more than that in young group （ P 〈 0. 05 ）. But in young and middle - aged group, improper diet, alcohol consumption and spiritual progress, fatigue inducement was significantly higher than that of

关 键 词：老年 上消化道出血 病因 症状 内镜检查 

分 类 号：R573.2[医药卫生—消化系统]