老年人上消化道出血134例临床分析

目的探讨老年人上消化道出血及导致死亡的病因。方法回顾性总结分析上消化道出血老年患者１３４例,并与同期非老年患者１２０例比较。结果老年人上消化道出血病因中主要为酸相关疾病（十二指肠溃疡、胃溃疡、胃炎、十二指肠炎、食管炎）７１例,占７３．９％;胃癌１４例,占１４．５％。发生低血压或休克,老年组１８例,非老年组８例（Ｐ＜０．０５）。使用阿司匹林或非甾体类抗炎药物,老年组２８例,显著高于非老年组（７例,Ｐ＜０．０１）。老年组死亡１８例,病死率为１３．４％,其中１５例因全身慢性疾病恶化和出血后并发症死亡;非老年组死亡６例,病死率为５．０％（Ｐ＜０．０１）。结论酸相关疾病是老年人上消化道出血的主要病因,其次为胃癌。全身慢性疾病恶化和出血后并发症是影响老年人上消化道出血预后的重要因素,特别是肺部感染、心脑血管疾病是主要的死亡原因。

A clinical analysis of 134 cases of upper gastrointestinal hemorrhage in the aged

Objective To investigate the causes of upper gastrointestinal hemorrhage and mortality rate in the aged. Methods The clinical data of 134 elderly patients with upper gastrointestinal hemorrhage were analyzed and compared with those of non aged patients with upper gastrointestinal hemorrhage in the same period. Results Among the elderly patients, 73 9% was caused by acid peptic diseases (duodenal ulcer, gastric ulcer, gastritis, duodenitis , esophagitis ) and 14 5% by gastric carcinoma. Eighteen cases died with a fatality rate of 13 4% Fifteen cases died from worsening of pre existing chronic diseases and complications due to hemorrhage,including pulmonary infection in 6 cases, cardiovascular and cerebrovascular diseases in 6 cases, malignancy in 2 cases and renal failure in 1 case. Conclusions Acid peptic diseases are the main cause of upper gastrointestinal hemorrhage in the aged. Gastric carcinoma is the second common cause. Pulmonary infection, cardiovascular and cerebrovascular diseases are the important factors influencing the prognosis of upper gastrointestinal hemorrhage in elderly patients.