90例急性上消化道出血病因的临床研究  

Clinical study on etiological ana lysis of 90 cases of acute upper gastrointestinal bleeding

作　　者：李娟[1] 张云丽[1] Li Juan;Zhang Yunli(Beijing Jingmei Group General Hospital,Beijing 102300,China)

机构地区：[1]北京京煤集团总医院,北京102300

出　　处：《首都食品与医药》2022年第7期22-23,共2页Capital Food Medicine

摘　　要：目的回顾性研究急性上消化道出血患者的病因。方法收集北京京煤集团总医院消化内科2018年12月-2021年11月住院的急性上消化道出血且经胃镜检查的90例患者临床资料,分析患者的病因。结果90例急性上消化道出血中男性61例,女性29例;急性上消化道出血病因分别为消化性溃疡(41.1%)、肝硬化食管胃底静脉曲张破裂出血(22.2%),贲门黏膜撕裂综合征(16.7%)、胃恶性肿瘤(7.8%)、反流性食管炎(5.6%)、十二指肠恶性肿瘤(3.3%)、胃毛细血管扩张症(2.2%)、十二指肠憩室出血(1.1%)。84例患者因呕血、黑便或呕血伴黑便就诊,6例因乏力、头晕就诊。胃镜尤其是急诊内镜在急性上消化道出血诊治中的应用,使患者的预后均比较好。结论急性上消化道出血患者中男性居多,急性上消化道出血病因中消化性溃疡位居首位,其次为肝硬化食管胃底静脉曲张破裂、贲门黏膜撕裂综合征,虽然急性上消化道出血为临床常见急症,但仍需积极询问病史,实施辅助检查,以便及时作出判断;在血流动力学稳定的情况下尽早开展胃镜检查并予以相应治疗,提高患者存活率;尤其以乏力、头晕就诊的患者需关注其大便颜色、血常规及便常规检查结果,警惕消化道出血可能。Objective To retrospectively study the etiology of acute upper gastrointestinal bleeding.The clinical data of 90 patients with acute upper gastrointestinal bleeding who underwent gastroscopy in the Department of Gastroenterology of Beijing Jingmei group general hospital from December 2018 to November 2021 were collected to analyze the etiology of the patients.Met hods The clinical data of 90 patients with acute upper gastrointestinal bleeding who underwent in the Department of Gastroenterology of Beijing Jingmei group general hospital from December 2018 to November 2021 were collected,and the etiology of the patients was analyzed.Resu I ts There were 61 males and 29 females in 90 cases of acute upper gastrointestinal bleeding.The causes were peptic ulcer(41.1%),rupture and bleeding of esophageal and gastric varices in liver cirrhosis(22.2%),cardiac mucosal tear syndrome(16.7%),gastric malignant tumor(7.8%),reflux esophagitis(5.6%),12-year-old finger intestinal malignant tumor(3.3%),gastric telangiectasia(2.2%),and duodenal diverticulum bleeding 84 cases were treated with hematemesis,black stool or hematemesis with black stool,and 6 cases were treated with fatigue and dizziness.Conclusion The majority of patients with acute upper gastrointestinal bleeding are men.Peptic ulcer ranks first among the causes of acute upper gastrointestinal bleeding,followed by liver cirrhosis,esophageal and gastric fundus varices rupture and cardiac mucosal tear syndrome.Therefore,although acute upper gastrointestinal bleeding is a common clinical emergency,it is necessary to make timely judgment by actively asking medical.

关 键 词：急性上消化道出血 胃镜检查 病因 

分 类 号：R573.2[医药卫生—消化系统]