上消化道出血病因趋势及相关因素分析

目的探讨近10年来上消化道出血（upper gastrointestinal bleeding，UGB）的病因构成、发病趋势及与几个相关因素的关系。方法对1995～2004年期间在我院行胃镜检查并明确病因的l909例上消化道出血病人的临床资料进行统计分析。结果①上消化道出血主要病因依次为十二指肠球部溃疡、食管胃底静脉曲张、胃溃疡、出血性胃炎、胃癌、复合性溃疡。其中十二指肠球部溃疡的发病呈上升趋势，胃癌所致出血则有下降趋势。②发生上消化道出血以中年组最多，其次是青年组，老年组最少，且青年人发病呈上升趋势。③上消化道出血男性病人明显多于女性病人。④上消化道出血及常见病因的发病多见于春秋冬季，夏季最少，但无统计学意义。结论十二指肠球部溃疡是上消化道出血最主要病因，且有上升趋势，其次是食管胃底静脉曲张、胃溃疡，而胃癌的发病构成有下降。上消化道出血的分布与年代变化、年龄、性别、季节等因素相关。

Analysis of etiological factor, tendency and correlative factors of upper gastrointestinal bleeding

Objective To investigate the etiopathogenisis constitution, incidence tendency and correlative factors of UGB in recent 10 years. Methods One thousand nine hundred and nine UGB cases who had been confirmed by endoscope in our hospital from 1995 to 2004 were studied and analyzed. Results The most common causes of UGB was duodenal bulb ulcer, and then were gastroesophageal varices, gastric ulcer, bleeding gastritis, gastric cancer and multiple ulcer in turn. The incidence of duodenal bulb ulcer had a tendency of increasing, the contrary gastic cancer had a descending tendency. The middle age group had more cases of UGB than the older and younger group, and ineidence in the older group was the lowest. Male patients with UGB were more common than female patients. UGB happened much more in spring, autumn and winter, but no significance in statistics. Conclusion Duodenal bulb ulcer is the most common causes of UGB and its tendency is ascending. The next were gastroesophageal varices and gastric ulcer. The occur- rence of UGB was in correlation with the varies of times, age, sex and season.