非甾体类抗炎药致上消化道出血56例临床剖析.docVIP

非甾体类抗炎药致上消化道出血56例临床剖析 　　【摘要】 目的 探讨非甾体抗炎药(NSAIDs)致上消化道出血的临床特点。方法 调查我科2007年1月至2010年4月,因服用NSAIDs致上消化道出血收住入院的56例患者的临床资料,对患者年龄、服药种类、临床表现、内镜特点及临床治疗等方面进行分析。结果 NSAIDs致上消化道出血以老年人尤为多见(62.5%),年龄越大症状越重,且疗效亦差。起病隐匿,主要表现为糜烂出血性胃炎及消化性溃疡。停用NSAIDs或对确需继续服用者换用小剂量、对胃肠损害小的药物,是治疗和预防NSAIDs胃肠黏膜损伤的关键。结论 NSAIDs是一把双刃剑,我们利用其治疗作用的同时,应加强对NSAIDs相关性上消化道出血临床特点的认识,尽量减少NSAIDs的不良反应。 　　【关键词】非甾体类抗炎药;NSAIDs;上消化道出血;消化性溃疡 　　 　　The clinical features of 56 cases with upper gastrointestinal bleeding induced by non- steroidal anti-inflammatory drugs 　　 　　LU Chen-xia. 　　Department of Gastroenterology,the Gaogang Peoples Hospital of Taizhou city,Jiangsu 225423,China 　　【Abstract】 Objective To investigate the clinical features of upper gastrointestinal bleeding(UGIB)induced by non-steroidal anti- inflammatory drugs(NSAIDs).Methods The clinical data of 56 patients,in hospital during January 2007 to April 2010,suffering from UGIB induced by NSAIDs,was analyzed,such as the age,the NSAIDs which were taken,clinical features,endoscopic features,therapeutic measure,and so on.Results UGIB caused by NSAIDs are particularly common in elderly people(62.5%),the older the seriouser the symptoms,and the poorer the effects of therapeutic measure.The onset of UGIB induced by NSAIDs is concealed,hemorrhagic gastritis and peptic ulcer are common endoscopic features.TO disuse,or continue taking NSAIDs with lower dose and less damage is the most important therapeutic measure.Conclusion As a double-edged sword,NSAIDs’ side-effects should be recognized and be minimized,While it’s therapeutic effects are used more and more widely. 　　【Key words】Non-steroidal anti-inflammatory agents; NSAIDs; Upper gastrointestinal bleeding; Peptic ulcer 　　 　　阿司匹林作为抗血小板活性药物,对冠心病、脑梗死的预防及治疗作用早已被医学界认定,但其促发胃肠道黏膜损伤,导致糜烂、溃疡甚至出血的副作用也逐渐受到重视。现将我科2007年1月至2010年4月,因服用NSAIDs致上消化道出血收住入院的56例病例,分析报告如下。 　　1 临床资料 　　1.1 一般资料 56例均为服NSAIDs后出现呕血和(或)黑便,而收住我科的患者,排除食管胃底静脉曲张、消化道肿瘤、炎症性肠病、贲门黏膜撕裂伤等,致上消化道出血者。其中男35例(62.5%),女21例(37.5%);年龄≤60岁21例(37.5%),60~80岁29例(51.8%),≥80岁6