目的：探讨老年上消化道出血病因及内镜治疗的临床疗效。方法选择上消化道出血并接受内镜治疗的386例患者为研究对象，其中老年患者186例，非老年患者200例。分析两组患者上消化道出血病因，并对内镜治疗效果进行评估。结果消化性溃疡、食管胃底静脉曲张、急性胃黏膜病变、胃癌是两组常见的上消化道出血病因，其中老年组胃溃疡、急性胃黏膜病变、胃癌比例显著高于非老年组(P<0.05)，而十二指肠溃疡及食管胃底静脉曲张发生率显著低于非老年组(P<0.05)；老年组与非老年组首次内镜止血成功率分别为91.9%和92.5%，差异无统计学意义(P>0.05)；老年组再出血发生率及病死率高于非老年组(P<0.05)；两组Rockall低危组、中危组及高危组首次内镜止血成功率依次降低(P<0.05)。结论老年上消化道出血患者胃溃疡、急性胃黏膜病变、胃癌发生率高，预后比非老年患者差。内镜治疗疗效确切，Rockall低、中危患者获益更显著。%Objective To explore the etiological analysis of upper gastrointestinal bleeding in elderly pa-tients and effect evaluation of endoscopic therapy. Methods A total of 386 patietns with upper gastrointestinal bleed-ing were selected as research subjects, including 186 elderly patients and 200 non-elderly patients. Etiology of upper gastrointestinal bleeding and effect of endoscopic therapy were studied. Results Peptic ulcer, esophageal and gastric varices, acute gastric mucosal lesion and gastric cancer were the main reasons for upper gastrointestinal bleeding in the two groups. The incidende of gastric ulcer, acute gastric mucosal lesion and gastric cancer were significantly high-er in elderly patients than non-elderly patients (P<0.05), while that of esophageal and gastric varices were significantly lower (P<0.05). The first hemostatic success rate were 91.9%and 92.5%in elderly patients and non-elderly patients, with no statistically significant difference (P>0.05). Compared with non-elderly patients, rehemorrhage rate and mor-tality rate in elderly patients were significantly higher (P<0.05). The first hemostatic success rate of Rockall low-risk group, moderate-risk group and high-risk group gradually decreased in two groups (P<0.05). Conclusion Compared with non-elderly patients, elderly patients have higher occurrence of gastric ulcer, acute gastric mucosal lesion and gas-tric cancer and poor prognosis. Endoscopic therapy has significant curative effect. The clinical benefit is more remark-able in Rockall low-risk group and moderate-risk group.
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