老年上消化道出血87例临床剖析.docVIP

老年上消化道出血87例临床剖析 　　【摘要】 目的 探讨老年上消化道出血的临床特点。方法 对87例老年上消化道出血患者的病因、临床表现、并发症、治疗及预后等方面进行回顾分析,并与同期住院的191例中青年上消化道出血进行对比。结果 ①老年人上消化道出血的病因依次为消化性溃疡、恶性肿瘤、急性胃黏膜病变、食管胃底静脉曲张破裂出血,其中消化性溃疡、恶性肿瘤发病率与中青年组相比具有显著性差异;②老年组的并发症、伴发病、再出血率、死亡率明显高于中青年组;③两组内科保守治疗治愈率差异具有统计学意义。结论 老年人上消化道出血以消化性溃疡多见,胃溃疡、胃癌发病率明显高于中青年组,且病程长,并发症、伴发病多,出血难控制,病死率高。 　　【关键词】 　　上消化道出血;老年人 　　 　　Clinical analysis of 87 cases old upper gastrointestinal hemorrhage 　　CHENGXiao-hua.Puyang City People’s Hospital,Henan Puyang,457000,China 　　 　　【Abstract】 Objective To investigate the clinical features and treatments of upper gastrointestinal hemorrhage in aged.Methods Retrospectively analyzed the cause,clinical manifestation,Complication,treatment and prognosis of 87 aged cases,and compared them with those of 191 young cases in hospital during the same time.Results First,the causes of upper gastrointestinal hemorrhage in aged were sequentially peptic ulcer,mucous membrane pathological change of acute stomach,digestive tract m alignant tumour and the oesophageal fundus of stomach breaks variceally.Among them compared with the young group the mobidity of peptic ulcer and m alignant tumour had significance differences.Second,the complications,accompanying illnesses,bleeding rate again and mortality of the aged group were obviously higher than the young group.Third,it had statistics meanings that two groups of departments of internal medicine guard and treat the cure rate difference.Conclusion In aged,peptic ulcer is also the main cause of upper gastrointestinal hemorrhage,but the morbidity of gastric ulcer and cancer was obviously higher than the young group.They had more course of disease,complications,accompanying illnesses,difficult to bleed to control and mortalities. 　　【Key words】 　　Upper gastrointestinal hemorrhage;The aged 　　 　　上消化道出血是指Treitz韧带以上的消化道出血,包括食管、胃、十二指肠、空肠上段以及来自胆道或胰管的出血,是老年人常见急症。老年人由于多合并其他疾病,且器官老化,生理功能亦有其特殊性,导致上消化道出血的病因、临床表现、并发症等与中青年患者有所不同。现就我院2004年10月至2009年4月收治的87例老年上消化道出血的临床资料进行回顾性分析,报告如下。 　　1 资料与方法 　　1