内科理论与实践2017，Vol.12Issue(6)：371-374,4.DOI:10.16138/j.1673-6087.2017.06.002
426例上消化道出血的病因分析
Retrospective analysis of etiology and relevant factors of 426 patients with upper gastrointestinal bleeding
丁燕飞 1俞骁珺 1陈平 1袁晓琴 1吴云林 1许兰涛 1忻笑容 1朱时燕 1谢玲 1周郁芬1
作者信息
- 1. 上海交通大学医学院附属瑞金医院北院消化内科,上海201801
- 折叠
摘要
Abstract
Objective To investigate the etiology and related factors of upper gastrointestinal bleeding (UGIB) in ouhospital during recent four years.Methods The clinical data of 426 patients with UGIB between January 2013 and December 2016 were collected.The etiology and related factors were retrospectively analyzed.Results ①The average age was (54.1±17.1) years old;ratio of male to female was 2.98:1.Young patients (＜40 years),middle-aged patients (40-59 years) and elderly patients (≥60 years old) accounted for 24.9％,31.7％,43.4％ of all the patients,respectively.②Peptic ulcer,esophagus and gastric varices and acute gastric mucosal lesion were the main causes of UGIB,and accounted for 67.4％,21.4％ and 3.8％ of the total cases,respectively.The proportion of varices decreased and the proportion of acute gastric mucosal lesion increased in 2015-2016 years compared with that in 2013-2014.③ Gastric ulcer was the main cause of UGIB in middle-aged and elderly patients (84.3％),while duodenal ulcer accounted for more in young people (43.6％)(P＜0.01).Esophagus and gastric varices were more common in the middle-aged and elderly patients (94.5％)(P＜0.01).Acute gastric mucosal lesion (81.3％) and gastric cancer(80％) accounted for more in the elderly(P＜0.01).④ Of the patients with peptic ulcer,137 (48.6％) were infected with Helicobacter pylori (Hp).Nonsteroidal anti-inflammatory drugs (NSAIDs),anticoagulants,glucocorticoids and other drugs were long-termly used in 39 (13.8％) of patients with peptic ulcer.Seven patients (2.5％) had both.Liver cirrhosis was the main cause of esophagus and gastric varices,in which post-hepatitis B cirrhosis accounted for 40.0％.Post-hepatitis B cirrhosis was more common in the middle-aged (66.7％) (P＜0.01).Patients with long-term use of NSAIDs,anticoagulants and glucocorticoids accounted for 37.5％ in patients with acute gastric mucosal lesion.Post-hepatitis B cirrhosis was the main cause of bleeding from portal hypertensive gastropathy.Conclusions The primary etiological cause of UGIB was peptic ulcer.The proportion of varices decreased and the proportion of acute gastric mucosal lesion increased in the past 2 years.Liver cirrhosis,Hp infection,the use of NSAIDs,anticoagulants and glucocorticoids were the relevant factors for UGIB.关键词
上消化道出血/病因/相关因素Key words
Upper gastrointestinal bleeding/Etiology/Relevant factor analysis分类
医药卫生引用本文复制引用
丁燕飞,俞骁珺,陈平,袁晓琴,吴云林,许兰涛,忻笑容,朱时燕,谢玲,周郁芬..426例上消化道出血的病因分析[J].内科理论与实践,2017,12(6):371-374,4.
