159例老年人下消化道出血病因分析  

Etiology of Lower Gastrointestinal Bleeding in 159 Elderly Patients

作　　者：王一鸣[1] 高娟[1] 熊毅敏[1] 徐维田[1] 程翌[1] 郑国荣[1] WANG Yi-ming GAO Juan XIONG Yi-min XU Wei-t-ian CHENG Yi ZHENG Guo-rong(Department of Gasiroenter- ology ,Wuhan General Hospital of Cruangzhou Command ,Wuhan Hwbei 430070,Chin)

机构地区：[1]广州军区武汉总医院消化内科,湖北武汉430070

出　　处：《华南国防医学杂志》2016年第9期574-576,共3页Military Medical Journal of South China

基　　金：武汉市中青年医学骨干人才培养工程

摘　　要：目的研究老年人下消化道出血的病因。方法选取作者医院2011/2015年159例60岁及以上下消化道出血患者作为观察组,并选取同期的167例中青年下消化道出血患者作为对照组,分析比较2组患者下消化道出血的病因。结果老年人下消化道出血的病因依次为肠道恶性肿瘤（54.1%）、缺血性结肠炎（18.9%）、肛周疾病（10.1%）、肠道息肉（5.0%）、溃疡性结肠炎（3.8%）和肠道血管畸形（2.5%）。其中老年和中青年肠道恶性肿瘤和溃疡性结肠炎在下消化道出血的病因构成比有统计学差异（χ~2=14.85,P〈0.01;χ~2=26.24,P〈0.01）。结论老年人下消化道出血的3大常见病因分别为肠道恶性肿瘤、缺血性结肠炎和肛周疾病,结肠镜检查是其首选检查治疗手段,选择性肠系膜动脉造影和320排动态容积CT（320-row dynamic volume CT,DVCT）小肠造影检查是结肠镜检查阴性的下消化道出血病因的有效诊断方法。Objective To investigate the etiology of lower gastrointestinal bleeding（LGIB）in the elderly.Methods A total of 159 elderly patients in authors＇ hospital greater than or equal to 60 year-old with LGIB from2011 to 2015 were chosen as observation group and 167 younger patients with LGIB less than 60 year-old were chosen as control group.An etiological analysis between two groups was carried out.Results The main causes of LGIB in the elderly were as follows：intestinal malignant tumor（54.1%）,ischemic colitis（18.9%）,crissum diseases（10.1%）,intestinal polyps（5.0%）,ulcerative colitis（3.8%）and intestinal vascular malformation（2.5%）.Among them,the constituent ratios of intestinal malignant carcinoma and ulcerative colitis in the etiologies of LGIB were significantly different between the elderly and younger patients（χ~2=14.85,P〈0.01;χ~2=26.24,P〈0.01）.Conclusion The three most common etiologies of LGIB in the elderly are intestinal malignant carcinoma,ischemic colitis and crissum diseases.Colonoscopy is the preferred initial test for elderly patients with LGIB,selective mesenteric artery radiography and 320-row dynamic volume computed tomography are also effective diagnostic methods for those with negative colonoscopy.

关 键 词：老年人 下消化道出血 病因 

分 类 号：R574[医药卫生—消化系统]