老年人上消化道出血临床特征分析

目的 探讨老年人上消化道出血临床特征。方法 回顾性总结分析486例老年人上消化道出血患者(A组)临床特征,并与同期498例非老年人上消化道出血患者(B组)进行对比分析。结果 A组伴随全身慢性疾病(包括高血压及心血管疾病、慢性呼吸系统疾病、脑血管疾病、慢性肾功能不全、2型糖尿病、恶性肿瘤)明显高于B组(P<0.01)。A组伴低血压或休克,服用阿斯匹林等非甾体抗炎药或糖皮质激素,死亡均明显高于B组(P<0.01)A、B两组出血病因均以消化性溃疡及酸相关性疾病(包括消化性溃疡、急性胃粘膜病变、十二指肠炎、食道炎)居多。A、B两组消化性溃疡分别占43.6％及50.6％,而且A组十二指肠溃疡明显低于B组(P<0.01)。A、B两组酸相关性疾病分别占64.2％及75.5％。A组原因不明出血明显高于B组(P<0.1)。结论 老年人上消化道出血常伴随全身慢性疾病,酸相关性疾病是老年人上消化道出血的主要病因。老年人上消化道出血原因不明及死亡率均较非老年人为高。

Analyse clinical characteristic of the elderly patients with upper gastrointestinal hemorrhage

Objective: To investgate the clinical characteristic of the elderly upper gastrointestinal hemorrhage. Methods: 486 elderly patients with upper gastrointestinal hemorrhage were retrospectively analyzed clinical character (group A.). and 498 nonelderly patients with upper gastrointestinal hemorrhage (group B) as control at the corresptonding period. Results: The rate of the personal chronic disease in group A (including hypertension and cardiovascular disease, chronic respiratory disease, cerebrovascular disease, chronic renal failure, type 2 diabetes mellitus, malignant tumor) was very higher than that of group B (P<0.01). The rate of hypotension or shock, taking non-steroid antiinfla-mmateory-immunity drug (such as aspirin) or steroid antiinflammateory-im-munity drug, death were all obvious higher than that of group B (P<0.01). Why the reason of haemorrhage mostly were peptic ulcer and acid relational disease (including peptic ulcer,acute gastrointestinal membrane trauma, duodenitis, esophagitis) both group A and group B. Rate of the peptic ulcer in group A was 43.6%, and that in group B was 50.6%, furthermore, the duod-enum ulcer rate of group A was obvious lower than group B (P<0.01). Rate of the acid relational disease in group A was 64.2%, and that in group B was 75.5%, It is a higher risk of unknown reason hemorrhage in group A than group B (P<0.01). Conclusion: There are often with the personal chronic disease in the elderly with upper gastrointestinal hemorrhage, acid relational disease is the primary reason in the elderly upper gastrointestinal hemorrhage, it is a higher risk of unknown reason hemorrhage and death than non-the older.