老年上消化道出血312例临床特点分析

目的探讨老年上消化道出血的病因及临床特点。方法对312例老年上消化道出血患者的临床资料进行回顾性分析。结果老年上消化道出血的主要病因依次为消化性溃疡、急性胃黏膜病变、食管静脉曲张、胃癌。其中胃溃疡出血发生率(31.4%,98/312)高于十二指肠溃疡的发生率(21.8%,68/312);临床表现不典型,以无症状、黑便为首发症状多见。伴随病58.0%(181/312)、并发症25.3%(79/312)、再出血率20.5%(64/312)、死亡率达11.2%(35/312)。结论老年上消化道出血仍以消化性溃疡多见,胃溃疡出血发生率增加且伴随病并发症多,再出血率和死亡率高。

Analysis on clinical characteristics of elderly upper gastrointestinal hemorrhage in 312 cases

Objective To explore the etiology and clinical features of elderly upper gastrointestinal hemorrhage.Methods The clinical data in 312 cases of elderly upper gastrointestinal hemorrhage were retrospectively analyzed.Results The main causes for elderly upper gastrointestinal bleeding in turn were acute gastric mucosa lesions,esophageal varices and gastriccancer.Among them,the incidence rate in gastric ulcer bleeding was 31.4%（98/312） and higher than 21.8%（68/312） in duodenal ulcer.The clinical manifestations were atypical and asymptomatic melena as initial symptom was common.In this case group,accompanying diseases accounted for 58.0%（181/321）,complications for 25.3%（79/312）,the rebleeding rate was 20.5%（64/312） and the mortality rate reached 11.2%（35/312）.Conclusion In elderly upper gastrointestinal hemorrhage,peptic ulcer is usual,the incidence rate of gastric ulcer bleeding is increased with more accompanying diseases and complications,and the high bleeding rate and mortality rate.