上消化道出血病因及发病趋势分析

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：对我院1993、1998和2003年间经内镜检查的UGB住院病人的临床资料进行统计分析。结果：（1）共检出UGB 2347例，1993年580例、1998年646例、2003年1121例。（2）消化性溃疡、急性胃粘膜病变、胃癌为UGB常见病因，分别占27．8％、21．1％、9．4％。（3）1993、1998和2003年三个年份中，急性胃粘膜病变分别占该年份UGB的24．3％、23．8％、17．9％；胃溃疡分别占8．3％、7．3％、4．5％；胃癌分别占6．0％、7．7％、12．0％；十二指肠溃疡分别占13．1％、19．8％、27．0％。（4）男性患者明显多于女性，男女之比为2．11：1。（5）随着年龄的增长，UGB的发病例数增加。（6）冬春两季的发病例数明显多于夏秋两季。结论：消化性溃疡是UGB的主要原因，其次是急性胃粘膜病变、胃癌。急性胃粘膜病变、胃溃疡的发病构成比呈下降趋势，差异有统计学意义（P〈0．01），胃癌、十二指肠溃疡的发病构成比呈上升趋势，差异有统计学意义（P=0．000）。UGB的病因分布与性别、年龄、季节、年代变化等因素相关。

Etiology and Incidence Tendency of Upper Gastrointestinal Bleeding

Objective:To investigate the causes,the incidence tendency and some relative factors of upper gastrointestinal bleeding(UGB) in the last ten years.Methods:Endoscopy was performed in the adults hospitalized for UGB in 1993?1998 and 2003.Results:(1)2347 UGB inpatients were enrolled in this study.There were 580 patients in 1993,646 in 1998,and 1121 in 2003.(2)The most common causes of UGB were peptic ulcer(27.8%),AGML(21.1%),and gastric cancer(9.4%).(3)The rates of AGML were 24.3% in 1993,23.8% in 1998,and 17.9% in 2003 respectively;those of gastric ulcer were 8.28%,7.28%,and 4.46%;of gastric cancer were(6.03)%,7.74%,12.04%,and of duodenal ulcer were 13.1%,(19.8)%,27.0%,respectively in 1993,1998,and 2003.(4)The male patients were more than female patients significantly.The ratio of male to female patients was 2.11:1.(5)The UGB patients increased with age.(6)The UGB patients in winter and spring were more than that in summer and autumn.Conclusion:The most common causes of UGB were peptic ulcer,AGML,and gastric cancer.In different years,the incidences of gastric ulcer and AGML had a tendency of yearly decreasing(P<0.01).The incidences of duodenal ulcer and gastric cancer had a tendency of increasing(P=0.000).Sex,age,weather alteration,and change of time were all correlative factors involved in the occurrence of UGB.