摘要
目的研究老年患者急性非静脉曲张性上消化道出血(acute non-varicose upper gastrointestinal bleeding,ANVUGIB)的临床特点。方法选择2013年1月-2018年12月于复旦大学附属华东医院住院的631例ANVUGIB患者为研究对象,按年龄分为观察组(≥65岁,284例)和对照组(<65岁,347例),观察并比较2组性别构成、伴随疾病、病因构成、临床表现、治疗方法、住院天数、医疗费用、再出血率和死亡率等特点。结果观察组和对照组男性构成比均高于女性(65.8%vs.34.2%、80.7%vs.19.3%);观察组有伴随疾病者占比明显高于对照组(89.4%vs.66%,P<0.05);观察组因胃溃疡导致出血者占比明显高于对照组(45.8%vs.31.3%,P<0.05);2组最常见的首发症状均为黑便;观察组输血率显著高于对照组(37.8%vs.9.2%,P<0.05);观察组平均住院天数及平均医疗费用均明显高于对照组[(11.3±5.1)d vs.(9.1±4) d,(14162±8570)元vs.(11191±8696)元,均P<0.01)];观察组与对照组再出血率差异无统计学意义(P>0.05);观察组死亡率明显高于对照组(P<0.05)。结论老年组和非老年组ANVUGIB性别构成相似,均为男性多于女性,但老年患者多病共存常见,最常见的出血原因为消化性溃疡,其中以胃溃疡多见,最常见的首发症状为黑便,腹部症状常不典型;老年患者花费高、预后差。
Objective To discuss the clinical characteristics of acute non-varicose upper gastrointestinal bleeding(ANVUGIB) in the elderly.Methods A total of 631 elderly with ANVUGIB hospitalized during the period from January 2013 to December 2018 were enrolled and were divided,according to their age,into 2 groups:observation group(≥65 years old)and control group(<65 years old);gender composition,concomitant diseases,etiological composition,clinical manifestations,treatment methods,days of hospitalization,medical expenses,re-bleeding rate,mortality rate and other characteristics of the elderly in the 2 groups were retrospectively analyzed and a comparative study was made between the 2 groups.Results The proportion of males was higher than that of females in observation group(65.8% vs.34.2%) and in control group(80.7% vs.9.3%);the proportion of cases with concomitant diseases in observation group was higher than that in control group(89.4% vs.66%,P<0.05);the proportion of bleeding caused by gastric ulcer in observation group was higher than that in control group(45.8% vs.31.3%,P<0.05);the most common first symptom in the 2 groups was black stools;the rate of blood transfusion in observation group was higher than that in control group(37.8% vs.9.2%,P<0.05);the average days of hospitalization and average medical expenses in observation group were both more than those in control group(11.3±5.1 days vs.9.1±4 days,14162±8570 yuan vs.11191±8696 yuan)(P<0.01);there was no statistical difference in re-bleeding rate between the 2 groups(P>0.05).the death rate in observation group was higher than that in control group(P<0.05).Conclusions ANVUGIB is found in males more than in females,the elderly are often with concomitant diseases;peptic ulcer,especially gastric ulcer,is the most common cause of bleeding;the most common first symptom is black stools;the abdominal symptoms are atypical;the elderly with ANVUGIB usually have high medical expenses and poor prognosis.
作者
陈金
虞阳
于晓峰
姚健凤
Chen Jin;Yu Yang;Yu Xiaofeng;Yao Jianfeng(Department of Gastroenterology.Huadong Hospital Affiliated to Fudan University,Shanghai 200040,P.R.China)
出处
《老年医学与保健》
CAS
2019年第6期763-766,共4页
Geriatrics & Health Care
关键词
老年
急性非静脉曲张性上消化道出血
消化性溃疡
首发症状
elderly
acute non-varicose upper gastrointestinal bleeding(ANVUGIB)
peptic ulcer
first symptom
