1520例上消化道出血病因和临床特点分析

目的研究近6年本院收治的上消化道出血患者的病因结构变化及临床发病特点。方法 对我院消化内科2004年至2009年1520例上消化道出血病人的临床资料进行回顾性调查分析。结果 （1）男性多于女性,男：女=3.4：1,平均年龄52.8岁（14～102岁）。死亡38例（2.5%）,52.6%死于大出血,47.4%死于非出血相关性疾病。（2）上消化道出血前5位病因依次是消化性溃疡、食管胃底静脉曲张、胃癌、食管-贲门黏膜撕裂症和急性胃黏膜病变。（3）大于60岁老年病人发病率呈上升趋势。2004～2009年发病情况如下：31.1%、31.9%、32.4%、42.7%、38.1%、50.5%,胃癌是其首要病因（21.6%）。结论 与过去参考文献相比,食管胃底静脉曲张发病不断上升,而急性胃黏膜病变发病明显下降。随年龄增加,十二指肠溃疡发病降低,胃溃疡和胃癌发病增加。老年病人占上消化道出血病人比例越来越大,尤其是合并严重基础疾病的老年病人有高危死亡风险,成为了临床治疗的重点。

Etiology and Clinical Characteristic of Upper Gastrointestinal Haemorrhage: Analysis of 1520 Cases

Objective To investigate the causes and clinical characteristic of upper gastrointestinal haemorrhage in the last 6 years.Methods A retrospective review of clinical records of 1 520 patients referred for UGIB between 2004~2009.Rusults（l）The male patients were more than female patients,the ratio of male to female patients was 3.4 ∶1.The mean age was 52.8 years（14~102 years）.38 patients died,52.6 percent died of hemorrhea,and 47.4 percent died of other causes.（2）The first five causes of UGIB were peptic ulcer,gastroesophageal varices,gastric cancer,Mallory-Weiss tear and acute gastric mucosal lesion.（3）The incidence of old patients had a tendency of increasing（31.1%,31.9%,32.4%,42.7%,38.1%,50.5%）,gastric cancer was the most important cause（21.6%）,Conclusion The morbility of gastroesophageal varices was rising,but acute gastric mucosal lesion was descending.The DU patients decreased with age,but GU and gastric cancer increased.The percentage of old patients was more and more,especially old patients with severity comorbidity were high risk of death,who become emphasis of clincal therapy.