摘要
目的探讨鄂西北地区近十年来上消化道出血(upper gastro intestinal bleeding,UGB)的病因及治疗方式的变化。方法回顾性分析湖北医药学院附属十堰市人民医院、太和医院、东风总医院2001～2010年确诊的1005例上消化道出血住院患者的临床资料。结果上消化道出血病因前5年构成比消化性溃疡、食管胃底静脉曲张、胃癌、急性胃黏膜病变、食管贲门黏膜撕裂综合征、糜烂性食管炎分别为55.1%、14.1%、6.6%、9.6%、3.5%、4%,后5年分别为29.9%、12.4%、17.5%、7.3%、2.2%、0.7%;消化性溃疡发病呈下降趋势,差异有显著性(χ2=42.146,P<0.001);胃癌发病呈上升趋势,差异有显著性(χ2=29.660,P<0.001);上消化道出血治疗方式前5年构成比药物治疗、手术治疗和介入治疗分别为75.6%、17.7%、6.7%,后5年分别为74.5%、8.0%、17.5%。其中内镜下治疗前5年22.6%,后5年82.5%:内镜治疗明显增加,差异有显著性(χ2=350.111,P<0.001);介入治疗明显呈上升趋势,差异有显著性(χ2=29.66,P<0.001),手术治疗差异无统计学意义(P>0.05)。结论近十年鄂西北上消化道出血的主要病因依旧为消化性溃疡、食管胃底静脉曲张、胃癌、急性胃黏膜病变;但消化性溃疡出血发病率明显降低,胃癌发病率略有增高。治疗方式依旧以药物治疗为主,介入治疗、内镜治疗明显增多。
Objective To investigate the causes and treatments of upper gastrointestinal bleeding（UGB） in northwest area of Hubei province during the period of nearly 10 years. Methods A retrospective analysis was carried out among 1 005 cases from 2001 to 2010 on causes and clinical characteristics of UGB. Results The main causes of UGB were peptic ulcer （PU） , the stomach esophageal varices （EGV） , gastric cancer, acute gastric mucosal lesions （AGML） , cardiaoesophagus, muco- sal tear syndrome and erosive esophagitis. In 2001 - 2005, of which the percentages were 55. 1% , 14. 1% , 6.6% , 9.6% , 3.5% ,4% respectively,and in 2006 - 2010 ,the percentages were 29.9% , 17.5%, 12.4% ,7.3% ,3.5% ,0.7% respective- ly. The percentage of PU decreased,and the difference was significant （ X2 = 42. 146,P 〈 0. 001 ）. The percentage of gastric cancer increased, and the difference was significant （X2 = 29.66 ,P 〈 0. 001 ）. The use of endoscope, medicine, surgery and in- tervention for UGB treatments. In 2001 -2005, the average percentages were 75.6%. 17.7% ,6.7% respectively, and in 2006 - 2010 ,the average percentages were 74.5% ,8% , 17.5%. The percentage of endoscopic therapy was 22.6% in 2001 - 2005, and the percentage was 82.5% in 2006 - 2010. The percentage of intervention therapy increased, and the difference was signifi- cant（ X2 = 29.66,P 〈0. 001 ）. The difference of surgery therapy was not significant. The percentage of endoscopic therapy in- creased, and the difference was significant （ X2 = 350.111, P 〈 0. 001 ）. Conclusion In nearly 10 years, the main cause of UGB in northwest area of Hubei province were PU,EVG,gastric cancer and AGML;Erosive esophagitis decreases significantly as. time goes, EGV, AGML decrease slightly. The main treatment is still medicine, lnterventional therapy and endoscopic therapy increase and surgical treatment decreases slightly.
出处
《临床消化病杂志》
2013年第2期73-75,共3页
Chinese Journal of Clinical Gastroenterology
基金
湖北医药学院科研立项基金(2011XS30)
