摘要
目的:探讨我院近4年来上消化道出血(UGIB)的病因构成及相关因素分析。方法 :收集2013—2016年间我院收治的426例UGIB住院患者的临床资料,按年龄分为青年组、中年组和老年组,对病因及相关因素进行回顾性分析。结果:(1)平均年龄(54.1±17.1)岁,男女比例2.98∶1。青年组、中年组、老年组占比依次为24.9%、31.7%、43.4%。(2)消化性溃疡、食管胃底静脉曲张、急性胃黏膜病变为住院患者UGIB常见病因,分别占67.4%、21.4%、3.8%,2015—2016年较2013—2014年食管胃底静脉曲张占比下降,急性胃黏膜病变占比上升(均P<0.05)。(3)胃溃疡以中老年为主(84.3%),十二指肠溃疡以青年组居多(43.6%)(P<0.01)。食管胃底静脉曲张以中老年为主(94.5%)(P<0.01),急性胃黏膜病变、胃癌以老年人为多见(81.3%、80.0%)(P<0.01)。(4)消化性溃疡患者中幽门螺杆菌(Hp)感染137例(48.6%),39例(13.8%)长期口服非甾体类消炎药(NSAIDs)、抗凝剂、糖皮质激素类药物,Hp感染并NSAIDs服用者7例(2.5%)。食管胃底静脉曲张病因以肝硬化为主(98.9%),其中乙型肝炎(乙肝)后肝硬化占40.0%,主要以中年患者多见(66.7%)(P<0.01)。急性胃黏膜病变患者中有口服NSAIDs及糖皮质激素类药物者6例(37.5%)。门脉高压性胃病患者病因也以乙肝后肝硬化为主(75.0%)。结论:UGIB以消化性溃疡为首要病因,近2年来静脉曲张总占比下降,急性胃黏膜病变占比上升。肝硬化、Hp感染、NSAIDs、抗凝剂、激素类药物的使用为UGIB主要因素。
Objective To investigate the etiology and related factors of upper gastrointestinal bleeding（UGIB） in our hospital during recent four years. Methods The clinical data of 426 patients with UGIB between January 2013 and December 2016 were collected. The etiology and related factors were retrospectively analyzed. Results（1） The average age was（54.1±17.1） years old; ratio of male to female was 2.98 ∶1. Young patients（40 years）, middle-aged patients（40-59 years） and elderly patients（≥60 years old） accounted for 24.9%, 31.7%, 43.4% of all the patients, respectively.（2）Peptic ulcer, esophagus and gastric varices and acute gastric mucosal lesion were the main causes of UGIB, and accounted for67.4%, 21.4% and 3.8% of the total cases, respectively. The proportion of varices decreased and the proportion of acute gastric mucosal lesion increased in 2015-2016 years compared with that in 2013-2014.（3） Gastric ulcer was the main cause of UGIB in middle-aged and elderly patients（84.3%）, while duodenal ulcer accounted for more in young people（43.6%）（P0.01）. Esophagus and gastric varices were more common in the middle-aged and elderly patients（94.5%）（P0.01）. Acute gastric mucosal lesion（81.3%） and gastric cancer（80%） accounted for more in the elderly（P0.01）.（4） Of the patients with peptic ulcer, 137（48.6%） were infected with Helicobacter pylori（Hp）. Nonsteroidal anti-inflammatory drugs（NSAIDs）, anticoagulants, glucocorticoids and other drugs were long-termly used in 39（13.8%） of patients with peptic ulcer. Seven patients（2.5%） had both. Liver cirrhosis was the main cause of esophagus and gastric varices, in which post-hepatitis B cirrhosis accounted for 40.0%. Post-hepatitis B cirrhosis was more common in the middle-aged（66.7%）（P0.01）. Patients with long-term use of NSAIDs, anticoagulants and glucocorticoids accounted for 37.5% in patients with acute gastric mucosal lesion. Post-hepatitis B cirrhosis was the main cause of bleeding
作者
丁燕飞
陈平
袁晓琴
吴云林
许兰涛
忻笑容
朱时燕
谢玲
周郁芬
俞骁珺
DING Yanfei;CHEN Ping;YUAN Xiaoqin;WU Yunlin;XU Lantao;XIN Xiaorong;ZHU Shiyan;XIE Ling;ZHOU Yufen;YU Xiaojun(Department of Gastroenterology, Ruijin Hospital North Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 201801, China)
出处
《内科理论与实践》
2017年第6期371-374,共4页
Journal of Internal Medicine Concepts & Practice
关键词
上消化道出血
病因
相关因素
Upper gastrointestinal bleeding
Etiology
Relevant factor analysis
