老年人药源性急性胃粘膜出血116例分析

目的:探讨老年人药源性急性胃粘膜出血的特点与防治对策。方法:对394例急性上消化道出血住院老年患者进行回顾性分析。结果:药源性急性胃粘膜病变出血患者116例,占29.4%。主要表现:黑便96.6%,呕血28.4%,上腹痛44.8%;内镜均见有不同程度的斑片状糜烂出血或/并浅表溃疡出血,多在高住胃体;相关药物:解热镇痛药81.0%,激素8.6%;既往有慢性胃病史者58.6%,空腹服药者62.9%。结论:老年人服用解热镇痛药、激素等药的机会较多,易致药源性急性胃粘膜病变,是老年人上消化道出血的重要原因之一。

Analysis of Acute Gastric Mucosal Lesions Hemorrhage Induced by Drugs in 116 aged Patients

Objective:To study the patterns of drug induced acute gastric mucosal lesions hemorrhage in aged pa- tients.Method:The study was based on retrospective review of 394 over 60-year-old patients with upper gastrointestinal hemorrhage examined with endoscopy in 24 hours in the hospital.Result:29.4% hemorrhage resulted from drug induced a- cute gastric mucosal lesions.Their chief symptoms were that melena took up 96.6%,hematemesis,28.4%,and abdomi- nal pain,44.8%.Its pathological appearances were plaque type erosion hemorrhage and/or superficial ulcer.81.0% hemorrhage was caused by antipyretic analgesics,8.6%,by glucocortisteroids,and 4.3%,by alcohol.58.6% of the old patients had chronic gastric disease history.62.9% took drugs when they were hungry.Conclusion:The use of singantipy- retic analgesics and glucocortisteroids is very common in old people,and it is the important factor that results in gastric mu- cosal damage and hemorrhage.So it is necessary to pay more attention to the adverse drug reaction and rational use of drugs.