老年急性非食管静脉曲张性上消化道出血的临床特征分析

目的 分析老年人急性非食管静脉曲张性上消化道出血的临床特征.方法 对本院2009年6月至2012年12月间收治的急性非食管静脉曲张性上消化道出血患者172例进行回顾性分析,其中老年患者56例作为研究组,中青年患者116例作为对照组.详细分析两组病因、临床特征、实验室及内镜检查结果等.结果 两组患者出血首要原因均为消化性溃疡,分别为62.5％和67.2％;研究组癌症占30.4％ （17/56）,显著高于对照组6.0％ （7/116）,差异有统计学意义（x2=18.609,P=0.000）;研究组使用非甾体抗炎药物占21.4％（12/56）,显著高于对照组7.8％（9/116）,差异有统计学意义（x2=6.584,P=0.01）;研究组患者幽门螺杆菌感染占83.9％ （47/56）,对照组患者幽门螺杆菌感染占81.0％（94/116）,两者比较差异无统计学意义（x2=0.214,P＞0.05）.治疗期间研究组发生低血压或休克者占19.6％（11/56）,显著高于对照组7.8％（9/116）,差异有统计学意义（x2=5.191,P＜0.05）;研究组输血量、止血时间均显著高于对照组（t=4.573,=5.027,P＜0.01）.结论 老年人急性非食管静脉曲张性上消化道出血病情较非老年人重,治疗更为复杂,临床医生应给予足够重视,提高治疗效果.

Analysis of clinical features of acute non-variceal upper gastrointestinal hemorrhage in old patients

Objective To analyze the clinical features of acute non - variceal upper gastrointestinal hemorrhage in old patients. Methods One hundred seventy- two old patients with acute upper gastrointestinal hemorrhage patients from Jun. , 2009 to Dec. ,2012 admit to Zhumadian Central Hospital were retrospectively analyzed, including 56 eases of old patients in study group and 116 cases of young patients in control group. The etiology, clinical features, laboratory findings and endoscop- ic results in the both groups were analyzed. Results The primary reason in both groups for bleeding were peptic ulcer, which was 62.5% and 67.2% respectively, rate of cancer in study group was 30.4% （ 17/56）, which was significantly higher than that in the control group （6.0% , Z2 = 18. 609,P =0. 000）. In the study group, 21.6% patients had the history of the use of NSAIDs, which was significantly higher than that in the control group（7.8% , x^2 = 6.584 ,P = 0.01 ）. in the study group, pa- tients with Helieobacter pylori infection was 83.9% （47/56） ; the control group patients with Helicobaeter pylori infection was 81.0% （94/116）, no statistical difference was found（ x^2 = 0. 214 ,P 〉 0.05 ）. During the treatment period, the incidence of hypotension or shock occurred in 19.6% patients in study group, which was significantly higher than that in control group （7. 8% , x^2 = 5. 191, P 〈 0.05 ）. Blood transfusion and the bleeding time in study group were both significantly higher than that in the control group （t =4.573, t =5.027,P〈0.01）. Conclusion The condition of acute upper gastrointestinal hemorrhage in old patients is more severe and the treatment is more complex. Therefore, enough attention should be paid to improve the thera- peutic effect.