兰州地区上消化道出血病因及相关因素分析

摘要

目的 探讨近30年兰州地区上消化道出血(UGIB)的病因及临床特点.方法 回顾性分析1982年1月～2011年12月收治的3490例UGIB患者的住院病历资料,按年龄及入院时间顺序分组,并详细记录临床、实验室及内镜检查结果,分析临床特点及病因变化.结果 ①前、后15年对比,老年组患者增加；且基础病变多(41.43％),再出血率高(17.6％),血尿素氮升高(10.3士14.4),组间差异有显著性(P＜0.05),而住院时间及最低血红蛋白等组间差异无显著性(P＞0.05).②消化性溃疡(PU)出血是青年及中年组UGIB的最主要病因,而AGML(25.1％)是老年组的最主要病因.前、后15年相比,PU总体呈下降趋势,其中DU较前明显减少,胃溃疡、复合溃疡及食管胃底静脉曲张出血(EVB)相对稳定.AGML出血较前明显增加.结论 老年患者已逐渐成为UGIB的主要发病人群,具有基础病变多、尿素氮升高、再出血率高等特点；消化性溃疡(PU)仍为兰州地区UGIB的主要原因,AGML成为老年患者UGIB的另一重要病因.%Objective To explore the etiology and clinical features of gastrointestinal bleeding (UGIB). Methods 3490 cases of UGIB patients were analyzed. Results The hospitalization time and the lowest hemoglobin group had no significant difference (P＞0. 05). The peptic ulcer (PU) bleeding was the most important cause of the youth and middle-aged group UGIB, while AGML (25. 1% ) was the most important cause of the elderly group. PU had downward trend. DU decreased significantly. The gastric ulcer, composite ulcers and esophageal varices bleeding (EVB) were relatively stable. The AGML bleeding marked increased in over the previous. Conclusion Elderly patients has gradually become the UGIB main disease groups, more with foundation lesions, elevated blood urea nitrogen, characteristics of rebleeding high rate. The peptic ulcer (PU) is still the main reason and AGML become another important cause of elderly patients with UGIB.