老年晚期癌症临终患者并发消化道出血的相关因素分析

摘要

Objective To investigate related factors of gastrointestinal bleeding in elderly advanced cancer hospice inpatients , in order to facilitate better control. Methods A retrospective investigation of the clinical data of the elderly advanced cancer hospice inpatients was done , 85 cases with gastrointestinal bleeding (experimentalgroup) were compared with 294 cases with non-gastrointestinal bleeding cases (control group). Results Multivariate logistic stepwise regression analysis showed:HP infection [odds ratios (OR) = 3.241,95% confidence interval (CI) 1.792~5.863], non-steroidal anti-inflammatory drugs (OR=3.080,95%CI 1.725~5.497), long-term heart and lung disease (OR=2.323,95%CI 1.315~4.105), stress (OR=1.858,95%CI 1.054 ~ 3.274), albumin (OR =0.760,95%CI 0.679~0.851), enteral nutrition (OR=0.499,95%CI 0.679~0.851) on gastrointestinal bleeding in elderly advanced cancer hospice inpatients were significant (P<0.05). Conclusions We should strengthen the surveillance of elderly advanced cancer hospice inpatients with gastrointestinal bleeding , to improve the quality of life,and according to the risk factors,the early diagnosis and treatment must be regarded.%目的：探讨老年晚期癌症临终患者发生消化道出血的相关因素，以利于合理防治。方法：回顾性调查老年晚期癌症临终住院患者，对85例并发消化道出血病例（观察组）与294例未并发消化道出血病例（对照组）进行比较分析。结果：因素Logistic 逐步回归分析显示：幽门螺杆菌感染[比值比（OR）＝3．241，95％置信区间（CI）为1．792～5．863]、非甾体类消炎药的应用（OR＝3．080，95％CI为1．725～5．497）、长期心肺疾病（OR＝2．323，95％CI 为1．315～4．105）、应激状态（OR＝1．858，95％ CI 为1．054～3．274）、血白蛋白（OR＝0．760，95％ CI 为0．679～0．851）、肠内营养（OR＝0．499，95％CI 为0．279～0．892）与老年晚期癌症临终患者并发消化道出血有相关性（均P＜0．05）。结论：加强老年晚期癌症临终患者消化道出血的监控，重视危险因素，早期预防和治疗，提高生活质量。