上消化道出血488例临床分析

目的探讨分析上消化道出血的临床特点。方法对2003年1月至2007年6月我科收治的488例上消化道出血病例进行回顾性分析。结果488例上消化道出血患者均行急诊胃镜检查，胃镜下的诊断率高达99．0％，其中消化性溃疡304例，占62．3％；急性胃黏膜病变62例，占12．7％；胃食管恶性肿瘤52例，占10．7％；食管胃底静脉曲张破裂出血35例，占7．2％；Mallory—Weiss综合征16例，占3．3％；食管炎9例，占1．8％；吻合1：7炎2例，占0．4％；十二指肠球炎4例，占0．8％；Dieulafoy病2例，占0．4％，原因不明2例，占0．4％。结论急诊胃镜检查是诊断上消化道出血原因的最好方法；消化性溃疡、急性胃黏膜病变、胃食管恶性肿瘤以及食管静脉曲张破裂出血为上消化道出血的主要原因。

Clinical analysis on 488 cases of upper gastrointestinal hemorrhage

Objective To explore the clinical characteristics of upper gastrointestinal hemorrhage. Methods Clinical data of 488 cases of upper gastrointestinal hemorrhage admitted during Junuary 2003 to July 2007 were retrospectively analyzed. Results Four hundred and eighty eight cases of upper gastrointestinal hemorrhage were undergone emergent gastroscopic examination and the causes of upper gastrointestinal hemorrhage were analyzed. The diagnostic rate of 488 cases was 99% under emergent gastroseopy. The main causes of upper gastrointestinal hemorrhage were peptic ulcer （62.3%）, gastrointestinal membrane trauma （12.7%）, esophageal and gastric carcinoma （10.7%）, esophageal varicosity （7. 2% ） , Mallory - Weiss syndrome （ 3.3 % ） , esophagitis （ 1.6% ） , anastomositis （0.4%） , duodenitis （0.8 % ） , Dieulafoy disease （0.4%） and indetermination （0.4%）. Conclusion Emergent gastroscopy is the best and effective method for determining causes of upper gastrointestinal hemorrhage. Peptic ulcer, acute gastrointestinal membrane trauma, esophageal and gastric carcinomas and esophageal varicosity are the main causes of upper gastrointestinal hemorrhage.