老年与中青年人上消化道出血的临床对比分析

目的分析老年人与中青年人上消化道出血的临床特点。方法回顾性分析417例上消化道出血住院病例资料，根据年龄分为老年组198例，中青年组219例。就两组患者的临床、实验室及内镜检查结果等方面进行比较。结果老年组与中青年组上消化道出血的首要原因均为消化性溃疡，分别为53．0％和61．6％，但是老年组胃溃疡患病率（23．7％）明显高于中青年组（12．8％）（P〈0．01），中青年组十二指肠溃疡患病率（39．7％）明显高于老年组（21．7％）（P〈0．01）。老年组应用阿司匹林／非甾体类抗炎药（NSAIDs）明显增多，达17．1％，中青年组仅为5．0％（P〈0．01）。与中青年组比较，老年组发生外周循环障碍、血尿素氮升高、需输血增多，平均住院时间延长（P〈0．05）。结论上消化道出血病因较多，应及时行内镜检查明确。老年人较中青年人病情重，病程长。酌情行内镜下治疗是安全有效的措施。

Clinical analysis of upper gastrointestinal hemorrhage in elderly patients and young-middle-aged patients

Objective To investigate the characteristics of clinical course in elderly patients and young-mid-dle-aged patients with upper gastrointestinal hemorrhage. Methods 417 hospitalized patients were divided into eld-edy group (≥60 yrs,198 cases) and young-middle-aged( <60 yrs,219 cases). All patients were diagnosed upper gastrointestinal hemorrhage by endoscopy. Results Endoscopy diagnosis included the first common cause to upper gastrointestinal hemorrhage was peptic ulcer, whereas more gastric ulcer were seen in elderly patients and more duo-denal ulcer were seen in young-middle-aged patients(23.7% vs 12.8%, 39.7% vs 21.7%, P <0.01). More eld-erly patients had a history of using Aspirin or NSMDs (17.1% vs 5.0%, P <0.01). The number of circulatory fail-ure and blood transfusion necessary were significantly increased, the mean duration of hospital stay was longer in eld-erly group than in young-middle-aged group(P<0.05). Conclusion The elderly patients have a more complicated clinical course than those young-mlddle-aged patients. Endoscopy is a necessary and effective method for both diagno-sis and treatment.