CAJ | 학술논문

目的探讨老年人上消化道出血的临床特点.方法回顾性分析2008年1月-2011年12月河池市第一人民医院收治的90例以上消化道出血为主要表现的老年患者的临床资料,并与同期中青年病120例比较.结果与中青年人相比,老年人上消化道出血存在明显诱因者较少见(37.8%),出血方式表现为呕血者较少见(21.1%),其伴随疾病(48.9%)和并发症(21.1%)较多,再出血率(17.8%)和病死率(11.1%)较高.出血病因中,老年人以胃溃疡最多见(30.0%),其次为胃癌(27.8%)及十二指肠溃疡(18.9%);而中青年人以十二指肠溃疡(34.2%)最多见,其次为食管胃底静脉曲张破裂(23.3%)及胃溃疡(15.8%).老年人胃溃疡及胃癌出血的发生率均高于中青年人,而十二指肠溃疡出血的发生率则低于中青年人(P<0.05).结论老年人上消化道出血以消化性溃疡多见,胃溃疡及胃癌出血的发生率较高,伴随疾病和并发症多,再出血率和病死率高.
목적탐토노년인상소화도출혈적림상특점.방법회고성분석2008년1월-2011년12월하지시제일인민의원수치적90례이상소화도출혈위주요표현적노년환자적림상자료,병여동기중청년병120례비교.결과여중청년인상비,노년인상소화도출혈존재명현유인자교소견(37.8%),출혈방식표현위구혈자교소견(21.1%),기반수질병(48.9%)화병발증(21.1%)교다,재출혈솔(17.8%)화병사솔(11.1%)교고.출혈병인중,노년인이위궤양최다견(30.0%),기차위위암(27.8%)급십이지장궤양(18.9%);이중청년인이십이지장궤양(34.2%)최다견,기차위식관위저정맥곡장파렬(23.3%)급위궤양(15.8%).노년인위궤양급위암출혈적발생솔균고우중청년인,이십이지장궤양출혈적발생솔칙저우중청년인(P<0.05).결론노년인상소화도출혈이소화성궤양다견,위궤양급위암출혈적발생솔교고,반수질병화병발증다,재출혈솔화병사솔고.
Objective To investigate the clinical features of upper gastrointestinal bleeding in elderly patients. Methods We retrospectively analyzed the clinical features of 90 aged patients with upper gastrointestinal bleeding treated in our hospital from January 2008 to December 2011,and compared them with those of 120 younger patients during the same period. Results Compared with the younger patients,aged patients had fewer known contributing causes for upper gastrointestinal bleeding(37.8%) and fewer aged patients exhibited upper gastrointestinal bleeding in the form of hematemesis(21.1%),but they had more underlying diseases(48.9%) and complications(21.1%),more bleeding recurrences (17.8%) and higher mortality(11.1%).The main cause of upper gastrointestinal bleeding in elderly patients was gastric ulcer(30.0%),gastric cancer (27.8%)and duodenal ulcer (18.9%),while the main cause inyounger patients was duodenal ulcer (34.2%),Esophageal and gastric varices (23.3%)and gastric ulcer (15.8%). The bleeding rate of gastric ulcer or gastric ancer in elderly patients was higher than that in younger patients,but the bleeding rate of duodenal ulcer in elderly patients was lower than that in younger patients (P<0.05). Conclusion In aged patients,peptic ulcer is the main cause of upper gastrointestinal bleeding,and the bleeding rate of gastric ulcer or gastric ancer is higher.They have more underlying diseases and complications,more bleeding recurrences and higher mortality.