连续观察内镜下胃肠黏膜损伤200例临床分析  

Observation of gastroduodenal lesions by gastroscopy:clinical analysis of 200 cases

作　　者：万军[1] 张子其[1] 吴本俨[1] 张建萍[1] 王亚红[1] 付永和[1] 

机构地区：[1]中国人民解放军总医院消化科,北京100853

出　　处：《中国实用内科杂志》2004年第4期219-221,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的　通过内镜观察探讨胃肠黏膜损伤与非甾体抗炎药 (NSAIDs)的关系。方法　连续观察了 2 0 0例内镜下胃肠黏膜损伤病例。根据是否服用NSAIDs药物将患者分为NSAIDs组 (Ⅰ组 )及非NSAIDs组 (Ⅱ组 )。结果　Ⅰ、Ⅱ组患者分别占 4 6 5 %及 5 3 5 % (P >0 0 5 )。与Ⅱ组比较 ,Ⅰ组中 >6 0岁者占 81 7% (P <0 0 0 1) ,无症状者占 5 8 8% (P <0 0 5 ) ,患心血管疾病者占 70 6 % (P <0 0 5 ) ,胃溃疡占 5 0 0 % (P <0 0 5 ) ,溃疡并发出血占 11 8% (P <0 0 1)。Ⅰ组合并上消化道出血的相对危险是Ⅱ组的 7 0 4倍 (χ2 =6 2 17,P <0 0 5 )。结论　NSAIDs相关性胃肠黏膜损伤具有较为特异的临床及胃镜下表现 ,其合并上消化道出血的危险性较高 ,应引起重视。Objective To evaluate the association between NSAIDs and gastroduodenal lesions by gastroscopy.Method Totally 200 consecutive unselected patients aged from 22-96 years were diagnosed as gastroduodenal lesions by gastroscopy.Those with gastroduodenal lesions were divided into NSAIDs-related and non-NSAIDs-related groups(groupⅠand groupⅡ) according to whether taking NSAIDs or not.Results Group Ⅰaccounted for 46.5% and group Ⅱ 53.5% (P>0.05).In group Ⅰ,there were 81.72% aged over > 60 years,58.82% without sympotom,70.59% with cardiovascular diseases,50% with gastric ulcers,11.83% with peptic ulcer accompanied by bleeding.All the percentages in groupⅠ were significantly higher than those of group Ⅱ.The relative risk for upper gastrointestinal bleeding in group Ⅰ compared with group Ⅱ was 7.04 (χ 2=6.217,P<0.05).Conclusions There are more special clinical and endoscopic manifestations in patients with NSAIDs-related gastroduodenal lesions.Should be raised for concerns a higher risk of the upper gastroduodenal bleeding in NSAIDs users.

关 键 词：内镜 胃肠黏膜损伤 胃镜 非甾体抗炎药 上消化道出血 

分 类 号：R57[医药卫生—消化系统]