75岁以上非静脉曲张性上消化道出血患者临床特点分析

Acute non-variceal upper gastrointestinal bleeding in patients over 75-year-old

  • 摘要: 目的 探讨75岁以上非静脉曲张性上消化道出血(acute non-variceal upper gastrointestinal bleeding,ANVUGIB)患者的临床特点、治疗方法及预后。 方法 收集2014年1月- 2015年12月于本院消化内科住院的57例ANVUGIB患者,将其中22例≥75岁患者作为研究对象(观察组),同期住院的35例< 75岁患者作为对照(对照组),回顾性分析两组临床表现、主要病因、住院周期、治疗及预后等。 结果 观察组男性16例,女性6例,平均年龄(84.40±4.83)岁;对照组男性23例,女性12例,平均年龄(42.63±15.20)岁。观察组出血次数> 3的比例(13/22,59.1%)较对照组(6/35,17.1%)明显增高(P=0.001),由消化系肿瘤引发出血概率(6/22,27.3%)较对照组(1/35,2.9%)明显增高(P=0.020),再出血比例(10/22,45.5%)较对照组(1/35,2.9%)明显增高(P=0.000 3),平均住院周期(15.73±6.34) d较对照组(6.95±3.28) d明显延长(P=0.000),死亡率(4/22,18.2%)较对照组(0/35)有所增加(P=0.037)。 结论 75岁以上ANVUGIB患者出血次数多,肿瘤引发出血率高,住院周期长,再出血风险及死亡风险大,临床医生应保持高度警惕。

     

    Abstract: Objective To investigate the clinical characteristics, treatment and prognosis of non-variceal upper gastrointestinal bleeding (ANVUGIB) in patients over 75-year-old. Methods Clinical data about 57 patients with ANVUGIB treated in our department from January 2014 to December 2015 were collected. Twenty-two aged patients (≥75 years) were in observation group, and 35 patients (< 75 years) were in control group. The causes of disease, clinical characteristics, co-morbidities, hospitalization period and prognosis of two groups were analyzed retrospectively. Results There were 16 males and 6 females in observation group with the mean age of (84.40±4.83) years, and 23 males and 12 females in control group with the mean age of (42.63±15.20) years. The ratio of hemorrhage> 3 times in observation group was more than control group with significant difference (13/22, 59.1% vs 6/35, 17.1%, P=0.001). The incidence of bleeding caused by digestive malignant tumor was significantly higher in observation group than control group (6/22, 27.3% vs 1/35, 2.9%, P=0.020). In addition, the re-bleeding ratio in observation group was much higher than control group (10/22, 45.5% vs 1/35, 2.9%, P=0.000 3), and the average hospitalization period of observation group was significantly longer than control group (15.73±6.34) d vs (6.95±3.28) d, P=0.000 3. The mortality of observation group was higher than control group (4/22, 18.2% vs 0/35, P=0.037). Conclusion ANVUGIB in patients older than 75 years usually accompanies with many kinds of other system diseases, more hemorrhage times, longer hospital stay, higher incidence of re-bleeding and higher risk of death, which needs to be paid more attention by clinicians.

     

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