NSAIDs相关消化性溃疡出血临床特点分析  

Clinical characteristics and analysis of NSAIDs-related peptic ulcer hemorrhage

作　　者：张兴光[1] 王佐妤[1] 陈金梅[1] 邓全军[1] 赵瑞红[1] 谢立群[1] ZHANG Xing-guang WANG Zuo-yu CHEN Jin-mei DEND Quan-jun ZHAO Rui-hong XIE Li-qun(Department of Gastroenterology, Affiliated Hospital of Logistics University of PAP, Tianjin 300162, China)

机构地区：[1]武警后勤学院附属医院消化科,天津300162

出　　处：《武警后勤学院学报（医学版）》2017年第6期489-492,共4页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨非甾体类抗炎药(nonsteroidal anti-inflammatory drugs,NSAIDs)相关消化性溃疡出血的临床特点,提高临床诊治效果。【方法】纳入2014年1月至2015年12月我院280例消化性溃疡出血住院患者,依据病因不同分为4组:非甾体类抗炎药(NSAIDs)组(65例)、幽门螺杆菌(Hp)组(74例)、Hp+NSAIDs组(68例)、非Hp+非NSAIDs组(73例),分析并比较4组临床特点之间的差异。【结果】NSAIDs组平均年龄均高于Hp组及非Hp+非NSAIDs组,而腹痛发生率低于Hp组及非Hp+非NSAIDs组,差异均有统计学意义(P<0.05);NSAIDs组黑便和休克发生率均高于Hp组,差异均有统计学意义(P<0.05);NSAIDs组血红蛋白下降及尿素氮升高程度均高于Hp组,差异均有统计学意义(P<0.05);NSAIDs组呕血发生率及尿素氮升高程度均较非Hp+非NSAIDs组高,差异有统计学意义(P<0.05)。【结论】对NSAIDs治疗患者,消化性溃疡腹痛症状不明显,常以呕血、黑便等消化性溃疡出血入院,加上这类患者年龄大、基础疾病多、出血程度重,应引起临床医生足够重视。【Objective】To investigate the clinical characteristics of nonsteroidal anti-inflammatory drugs（NSAIDs） related peptic ulcer hemorrhage and improve the clinical therapeutic efficacy.【Methods】A total of 280 inpatients with peptic ulcer hemorrhage were enrolled in our hospital from January 2014 to December 2015. According to the pathogenesis, they were divided into 4 groups： NSAIDs group（65 cases）, helicobacter pylori（Hp） group（74 cases）, Hp＋NSAIDs group（68 cases） and non Hp＋ non NSAIDs group（73 cases）.The clinical characteristics were analyzed and compared between the 4 groups.【Results】The average age in the NSAIDs group was older than that in the Hp group and non Hp ＋ non NSAIDs group（P〈0.05）. The incidence of abdominal pain in the NSAIDs group was lower than that in the Hp group and non Hp ＋ non NSAIDs group（P〈0.05）. The incidence of black stool and shock in the NSAIDs group was higher than that in Hp group（P〈0.05）. Compared with the Hp group, the hemoglobin level was lower while the blood urea nitrogen level was higher in the NSAIDs group（P〈0.05）. Compared with the non Hp ＋ non NSAIDs group, the incidence of hematemesis was higher and blood urea nitrogen level increased more in the NSAIDs group（P〈0.05）.【Conclusion】As for the patients treated with NSAIDs, they are frequently seen in the elderly with more basic diseases and heavy hemorrhage and admitted to hospital for hematemesis and black stool but slight abdominal pain. Therefore, clinical doctors should pay enough attention to these patients.

关 键 词：消化性溃疡 幽门螺杆菌 阿司匹林 非甾体类抗炎药 

分 类 号：R322.4[医药卫生—人体解剖和组织胚胎学]