老年上消化道出血58例诊治分析

目的探讨老年上消化道出血的临床特点和治疗效果。方法选择2007年12月至2009年12月在我院就诊的老年上消化道出血患者58例,分析其胃镜检查结果及合并疾病。明确诊断后均给予补充血容量、凝血酶口服、垂体后叶素滴注等相应治疗;消化性溃疡或者急性胃炎出血者,给予甲氰咪胍或者雷尼替丁;行胃镜下止血。结果本组58例,其中41例经积极治疗后,没有再出现呕血和合并症,大便隐血试验阴性,占70.69%;8例患者死亡;转外科手术治疗9例。在止血方法中,凝血酶口服止血39例,采用胃镜止血11例。结论老年上消化道出血患者病死率高,凝血酶口服止血简便易行,胃镜下直接喷洒止血效果显著。

Analysis of Diagnosis and Treatment of 58 Cases with Upper Gastrointestinal Bleeding in the Elderly

Objective To investigate the clinical features and treatment of upper gastrointestinal bleeding in the elderly. Methods 58 elderly patients with upper gastrointestinal bleeding from December 2007 to December 2009 in our hospital were selected to analyze the gastroscopy results and complicated diseases for endoscopic hemostasis. Results Of the 58 patients,41 patients（70.69%） had no hematemesis and complications after active treatment,with negative fecal occult blood test;8 patients died;and 9 cases were transferred to surgery. Conclusions Elderly patients with upper gastrointestinal bleeding have high mortality,for whom oral thrombin hemostasis is simple,and direct spraying hemostasis under gastroscopy has remarkable effect.