十年间上消化道出血发病、诊治及预后的临床分析  

Clinical analysis of incidence and prognosis of upper gastrointestinal tract hemorrhage disease for ten years

作　　者：王菲[1] 张丹[1] 王允野[1] 

机构地区：[1]吉林医药学院附属医院消化二科,吉林吉林132013

出　　处：《中国医药科学》2016年第19期189-191,201,共4页China Medicine And Pharmacy

摘　　要：目的分析我院十年来收治上消化道出血年龄构成、病因构成、死亡率、输血率、再出血率的变化。方法回顾性分析我院2005-2014年10年间的上消化道出血病例1156例,收集病例资料进行比较分析。结果 A组、B组的年龄构成比,青年组比例下降,老年组比例增高,但差异无统计学意义。采用t检验比较两组青年组、中年组、老年组的平均年龄,其中青年组、老年组差异有统计学意义（P〈0.05）,青年组发病平均年龄下降,老年组平均年龄上升。两组病因构成比较,消化性溃疡仍是主因,其发病率有所下降（χ^2=8.185,P〈0.05）。胃癌及食道胃底静脉曲张、门脉高压性胃病比较,差异无统计学意义（χ^2=0.921,P〉0.05）、（χ^2=0.095,P〉0.05）。急性糜烂出血性胃炎发病明显增加（χ^2=13.173,P〈0.05）,从第3病因升至第2病因。结论上消化道出血发病有老年化趋势,病因仍以消化性溃疡为主,急性糜烂出血性胃炎发病明显增加。两组对比,死亡率、再出血率、输血率均有明显下降。死亡原因多以静脉曲张为主,非静脉曲张出血患者多是老年,和（或）伴有恶性肿瘤或多脏器衰竭患者。Objictive To analyze the age composition,causes,mortality,the rate of blood transfusion, and changes in the rate of hemorrhage of upper gastrointestinal bleeding in ten years. Methods 1156 cases of clinical data of upper gastrointestinal hemorrhage admitted in our hospital from October 2005 to October 2014 were retrospectively analyzed. And the case data were gathered and compared. Results By comparing the proportion of age in group A and B,the proportion of youth group was decreased, and the proportion of elder group was increased,but the difference was not significant. T-test were used to compare the average age of the youth group,the middle-aged group and the old group. The difference between the young group and the elder group was statistically significant（P〈0.05）. The average onset age of the young group was decreased,and the average onset age of the elderly group was increased. Comparing the two group of etiology,peptic ulcer was the main reason, its incidence had declined（χ^2=8.185,P〈0.05）.Comparing the gastric cancer, esophageal varices, portal hypertensive gastropathy, there were no significant difference between the two groups（χ^2= 0.921,P〉0.05）,（χ^2= 0.095,P〉0.05）.The incidence of acute erosive hemorrhagic gastritis was significantly increased from the third cause to the second cause（χ^2= 13.173, P〈0.05）. Conclusion The incidence of upper gastrointestinal bleeding has a tendency of aging, etiology is still mainly peptic ulcer,the incidence of acute erosive hemorrhagic gastritis bleeding increased significantly.Comparing the two groups, the mortality, rebleeding rate and blood transfusion rate were significantly decreased. Most of the causes of death mainly esophageal and gastric variceal bleeding, the death of non-variceal bleeding is mainly elderly patients and（or） the patients with malignant tumor or multiple organ failure.

关 键 词：上消化道出血 病因 发病率 死亡率 

分 类 号：R573.2[医药卫生—消化系统]